Glycaemic Status Among Neonates in Perinatal Asphyxia with Hypoxic Ischaemic Encephalopathy (Stage II and Stage III) in a Tertiary Level Hospital

Abstract

Background: Perinatal asphyxia is major cause of neonatal mortality and morbidity. Hypoxic ischaemic brain injury is the most important consequences of perinatal asphyxia which ultimately results in immediate and delayed form of neuronal death. The aim of this study was to find a relationship between glycaemic status and immediate outcomes of perinatal asphyxia. Methods: This prospective study was carried out in Department of Paediatrics, Shaheed Suhrawardy Medical College Hospital, from 16th April 2019 to 15th October 2019. Total 100 term asphyxiated newborn babies with HIE (Stage II and III) admitted within 24 hours were enrolled according to selection criteria, Blood glucose level and other relevant tests were done in all included patients. Results: The mean age of the neonates was 6.31±0.91 hours. Among the patients, 60% were male and 40% were female. Most cases (65%) had normal birth weight, while 35% were low birth weight. Common clinical features included respiratory distress (59%), poor feeding (75%), lethargy (33%), grunting (48%), and petechiae (6%). Moderate encephalopathy (Stage II) was observed in 63% of cases, and severe asphyxia (Stage III) in 37%. Hypoglycaemia was present in 26% of neonates, hyperglycaemia in 3%, and 71% had normal glucose levels. Hypoglycaemia was significantly associated with severe asphyxia, occurring in 45.9% of severe cases compared to 14.2% of moderate cases (p<0.05). Conclusion: There was significant association between glycaemic abnormalities with severity of perinatal asphyxia and immediate outcome of the asphyxiated newborn.