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

Abstract

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.

Evaluation of the efficacy of systemic inflammatory indices in determining mortality in very low birth weight infants

“…SII values of ≤28.87 were related to the predictivity of mortality. Moreover, GW and BW were lower in VLBW infants who died, while RDS and IVH were found to be more frequent 2 .…”

“…The use of Apgar scores to evaluate mortality and clinical outcomes in preterm infants is limited. The use of laboratory parameters in addition to clinical scores may be more useful in predicting mortality, especially in VLBW infants [2][3][4] . For this purpose, systemic inflammatory indices were evaluated in our study in order to assist in the early and effective estimation of mortality, especially in VLBW infants who were at higher risk for mortality.…”

“…Thus, the SII value can be a new and active parameter. As the SII value was effective, rapid, and readily available obtained from blood counts in VLBW infants, it may also provide an advantage as it can show mortality without additional costs [2][3][4] .…”

“…Moreover, it is clear that, besides reducing mortality, effective/ reliable parameters to predict mortality can provide valuable information about the prognosis of preterm infants to pediatricians, neonatal specialists, and families. Therefore, the search for new markers that can predict the prognosis of the preterm infant still continues [2][3][4] .…”

“…The most important factors affecting neonatal mortality are gestational week (GW) and birth weight (BW) 1 . Preterm infants may require a variety of diagnostic and therapeutic interventions depending on their GW, BW, and medical conditions 2 . Determining the risk factors that affect mortality and taking precautions for these risk factors help to reduce mortality 3 .…”