Abstract
Background: Perinatal asphyxia is one of the leading causes of perinatal morbidity and mortality. Feasible and early biochemical marker to diagnose and predict neurologic outcome is a great need of time as Apgar score alone is influenced by various factors. This study was conducted to validate the utility of urinary uric acid to creatinine ratio (UA/Cr ratio) in asphyxia diagnosis.
Aim: To validate the urinary uric acid/creatinine ratio as an additional marker for perinatal asphyxia.
Materials and Methods: The present case control study was conducted at a tertiary care superspeciality Hospital associated with medical college. Data of 50 healthy newborns and 79 asphyxiated newborns were collected. (UA/Cr) ratio was measured from the spot urine sample collected within 24 hours of birth. Statistical analysis was performed by student t-test and Receiver Operating Characteristic (ROC) plots.
Results: In our study the mean value of urine UA / Cr ratio among the cases was 2.632 and among controls was 0.866 (p <0.0001) and UA /Cr as an individual variable were statistically significant. ROC curve analysis done proved that a score of 1.92 or more delineates babies into asphyxiated newborns. A score of 1.9 has a sensitivity of 94.8% and specificity of 94% and area under the ROC curve is 0.995.
Conclusions: diagnosis of perinatal asphyxia should be supported by other investigations so that early decision can be taken about the level of care and prognosticate the baby. Interleukins, enzymes and imaging techniques require experienced personnel well equipped laboratories and are expensive. Non-invasive urinary UA/Cr ratio may be an answer to these issues as it easy, time and cost effective.
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Manish Kumar
Senior resident, Pediatric intensive care unit, Dept of pediatric, Dr RML Hospital, PGIMER
Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Phone no- 7091974966
DOI: https://dx.doi.org/10.18535/jmscr/v5i7.136
