Study of Urinary Uric Acid and Creatinine Ratio as a Marker of Perinatal Asphyxia and Its Correlation with Different Stages of Hypoxic Ischemic Encephalopathy

Choudhary, Lokesh; Palsania, Subhash; Berwal, PK; Sauparna, Chhavi; Maheshwari, Ankit

doi:10.4172/2376-127x.1000336

Cited by 5 publications

(4 citation statements)

References 8 publications

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“…Our study showed a significant higher ratio of UUA/ Cr in premature neonates admitted in NICU suffering hypoxia. Several other studies have reached similar results [2,3,6,8,9,[13][14][15][16][17][18][19][20][21]. In the case -control study of Sreekrishna et al on 50 normal neonates and 50 newborn infant with asphyxia, the mean Urinary Uric Acid / Cr ratio in case and control group was 2.8 ± 0.9 and 0.8 ± 0.2 respectively which shows a significant higher ratio in case group (P < 0.001) [2].…”

Section: Discussionsupporting

confidence: 59%

The Urinary Uric Acid / Cr ratio as a marker of morbidity and mortality of preterm infants: a case—control study

et al. 2021

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Background Perinatal asphyxia is one of the main causes of preterm infant mortality. Some studies have shown that The Urinary Uric Acid / Cr (UUA/Cr) ratio may be used as an additional marker for perinatal asphyxia.This study intend to investigate the relationship of this ratio with outcomes of preterm infants admitted to NICU. Methods This case–control study was carried on 102 preterm newborn infants with gestational age of 30 weeks to 33 weeks and 6 days admitted in the neonatal intensive care unit.The case group, consisted of 51 premature neonates with a history of intubation, cardiopulmonary resuscitation, mechanical ventilation and Nasal continuous positive airway pressure (NCPAP) at birth, were compared with 51 matched neonates. The UUA/Cr ratio was measured in the first 24 h after birth. Complications during hospitalization, duration of hospitalization, and final outcome were evaluated. Results The mean level of UUA/Cr ratio in case and control group were 5.4 ± 4.1 and 3.6 9 ± 2.9 respectively and this difference was statistically significant (p = 0.014). The UUA/Cr ratio were significantly higher in females, cesarean section delivery, Apgar score ≥ 8, neonates without any complication and neonates with less than 10 days of hospitalization. However, this ratio has no predictive value for the incidence of complications during hospitalization and long-term hospital stay for infants of the case group. Conclusions The Urinary Uric Acid / Cr ratio in the first 24 h after birth in preterm neonates who underwent intubation, NCPAP or cardiopulmonary resuscitation was higher than healthy neonates.

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Section: Discussionsupporting

confidence: 59%

The Urinary Uric Acid / Cr ratio as a marker of morbidity and mortality of preterm infants: a case—control study

et al. 2021

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“…There are not many studies that determine the utility of UA/Cr as a marker for the outcome. Choudhary et al [13] proved a significant positive correlation between the urine UA/Cr and different stages of HIE classified according to Sarnat and Sarnat staging. Urine UA/Cr was significantly higher in severe HIE (3.61±0.61) when compared to neonates with moderate HIE (2.95±0.98) and mild HIE (2.64±0.25) with a p<0.001.…”

Section: Discussionmentioning

confidence: 99%

Urine Uric Acid Creatinine Ratio as a Diagnostic and Prognostic Marker of Neonatal Birth Asphyxia

Krishnan

Nayak

Bellipady

et al. 2020

AJCPN

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Background: Cerebral hypoxia can result in anaerobic glycolysis which leads to decreased phosphorylase production and increased uric acid which gets excreted in the urine where it can be easily detected. The aim of the study is to assess the utility of urine uric acid creatinine ratio (UA/Cr) as an additional marker of neonatal depression and birth asphyxia and its utility as a potential prognostic indicator for the immediate outcome. Subjects and Methods: It was a case-control study that included 30 newborns born with an APGAR score of less than 7 at 1-min and requiring positive pressure ventilation. Cases were sub-grouped into neonatal depression and birth asphyxia. Newborns with moderate and severe encephalopathy were considered to have an unfavourable outcome. The urine UA/Cr was estimated in both groups. One-way Anova test, Spearman’s rho and Receiver Operating Characteristic curve were used for statistical analysis. Results: The mean differences of urine UA/Cr were statistically significant (p=0.011) in birth asphyxia (3.02 1.34), neonatal depression (2.31 0.81) and controls (2.01 0.69). A significant negative correlation was seen with APGAR at 1-min (r=-0.43; p=0.001) and 5-min (r=-0.52; p=0.001) and umbilical cord blood pH (r= -0.29; p=0.021). The mean difference of UA/Cr between those with unfavorable (3.23 1.49) and favourable (2.14 0.73) outcomes was significant (p=0.006). A ratio 2.85 suggested the unfavourable outcome. Conclusion: The urine UA/Cr is a useful diagnostic and prognostic biomarker in newborns with birth asphyxia.

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“…The ratio was significantly higher in severe HIE (3.61±0.61) when compared with moderate HIE (2.95±0.98) and with mild HIE (2.64±0.25, p<0.01). [19] As the number of neonates with severe asphyxia was low in our study, the comparison of the ratio in varying severity of HIE could not be done.…”

Section: Discussionmentioning

confidence: 80%

Urinary uric acid to creatinine ratio as a marker of perinatal asphyxia and its correlation with arterial blood gas values

Sharma¹,

Devimeenakshi²

2021

Perinatal J

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Objective Perinatal asphyxia is a leading cause of neonatal morbidity and mortality in developing countries. Lack of facilities like arterial blood gas analysis in resource limited settings warrants cost effective methods to support the diagnosis of asphyxia. The study objectives were to evaluate the utility of urinary uric acid to creatinine ratio (UA/Cr ratio) as a marker of perinatal asphyxia and to ascertain its correlation with cord blood arterial blood gas values. Methods It was a prospective comparative study where cases and controls were of asphyxiated neonates and normal neonates respectively delivered in a tertiary care medical college hospital from April 2019 to September 2019. Urinary UA/Cr ratio and its correlation with Apgar score was determined. The ability to predict asphyxia was estimated by ROC curve and p<0.05 was considered as statistically significant. Results Data from 38 asphyxiated and 38 normal neonates were analyzed. The mean urinary UA/Cr ratio was higher in the asphyxiated babies. There was negative correlation between urinary UA/Cr ratio and pH, pO2, Apgar scores and positive correlation with pCO2. The urinary UA/Cr ratio had excellent predictive validity for perinatal asphyxia determined by ROC curve. The urinary uric acid /creatinine ratio had sensitivity of 92.11% and specificity was 92.11%. Conclusion Urinary uric acid to creatinine ratio correlated well with the cord blood arterial blood gas values and the Apgar scores. This study showed that there is a significant increase in the urinary UA/Cr ratio in asphyxiated neonates and it can be used as a biochemical marker of perinatal asphyxia.

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Study of Urinary Uric Acid and Creatinine Ratio as a Marker of Perinatal Asphyxia and Its Correlation with Different Stages of Hypoxic Ischemic Encephalopathy

Cited by 5 publications

References 8 publications

The Urinary Uric Acid / Cr ratio as a marker of morbidity and mortality of preterm infants: a case—control study

The Urinary Uric Acid / Cr ratio as a marker of morbidity and mortality of preterm infants: a case—control study

Urine Uric Acid Creatinine Ratio as a Diagnostic and Prognostic Marker of Neonatal Birth Asphyxia

Urinary uric acid to creatinine ratio as a marker of perinatal asphyxia and its correlation with arterial blood gas values

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