Title: Evaluation of Serum Creatine Kinase Muscle-Brain Fraction (CK-MB) and Lactate Dehydrogenase (LDH) as Markers of Perinatal Asphyxia in Term Neonates at Tertiary Health Care Centre in Bikaner
Authors: Dr Kuldeep Meena, Dr R.K.Soni, Dr Nishaat Ahmed, Dr Nitesh, Prerna Harsh
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.148
Abstract
Background: Perinatal asphyxia is a common neonatal problem and contributes significantly to neonatal morbidity and mortality. Globally, hypoxia of the newborn (birth asphyxia) or the fetus ("fresh stillbirth") is estimated to account for 23% of the 4 million neonatal deaths and 26% of the 3.2 million stillbirths each year.
Material and Methods: Prospective observational study. A study was conducted on 50 neonates comprising the cases and 50 neonates comprising the controls meeting the inclusion and exclusion criteria. The blood samples for CK-MB and LDH was drawn at 8±2 and 72±2 hours of age respectively and sent for analysis. A serum CK-MB value >92.6 U/L at 8 hours and LDH value >580 U/L at 72 hours was taken as the cut-off level.
Results: The cut-off CK-MB value of >92.6 U/L has 28% sensitivity with a specificity of 100%. CK-MB has a positive predictive value of 100% with a negative predictive value of 58.14%. The cut-off LDH value of >580 U/L has 59.18% sensitivity with a specificity of 92%. LDH has a positive predictive value of 87.88% with a negative predictive value of 69.70%.
Conclusion: Estimation of CK-MB at 8 hours of life and LDH at 72 hours of life can help distinguish an asphyxiated from a no nasphyxiated term neonate in correlation with history and clinical features in the neonate.
Keywords: Perinatal asphyxia, Creatine kinase muscle-brain fraction (CK-MB), Lactate dehydrogenase (LDH), hypoxic ischemic encephalopathy (HIE).
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