Journal of AdvancedMedical and Dental Sciences Research

Introduction: Perinatal asphyxia is a major cause of neonatal death worldwide. Hypoxic ischemic encephalopathy affects the tissues and it can lead to brain damage. The present study was aimed (a) To estimate urinary uric acid and creatinine levels in spot urine sample. (b) To correlate the urinary uric acid, creatinine ratio with severity of hypoxic ischemic encephalopathy. Materials & methods: This prospective study was conducted at Department of Paediatrics in RL Jalappa Hospital & Research Centre attached to Sri Devaraj Urs Medical College, Karnataka. A total of 108 term babies with ≥37 weeks of gestations with hypoxic ischemic encephalopathy were included. The babies who have suffered asphyxia and as per standard staging system (SARNAT AND SARNAT) which fit in to the criteria of Hypoxic Ischemic Encephalopathy be categorized in to stage 1, stage 2 and stage 3 were included in this study. The random urine samples were collected and analyzed for urinary uric acid and creatinine. P< 0.05 was considered significant. Results: In the present study, out of 108 neonates, 36 subjects had HIE 1, 40 had HIE 2 and 32 had HIE 3. Among the HIE 1 subjects, the median urine uric acid was 34 (17.25, 75.75), HIE 2 was 38.20 (20.75, 57.50) and HIE 3 was 35.50 (28, 60.45). Among the HIE 1 subjects, the median urine creatinine was 23.25 (14, 45.75), HIE 2 was 16.90 (10, 31.25) and HIE 3 was 10 (7.55, 15.05). The difference in the urine creatinine across HIE was statistically significant (P Value <0.001). Among the HIE 1, the median ratio was 1.26 (1.06, 2.20),HIE 2 was 2.07 (1.87, 2.50) and HIE 3 was 3.47 (2.85, 4.57). The difference in the ratio across HIE was statistically significant (P Value <0.001).A positive correlation was noted between severity of HIE and urinary uric acid creatinine ratio with r =0.6 and statistically significant value p =0.001 noted. Conclusion: Urinary UA/Cr ratio is an accessible, non-invasive, painless and cost-effective, single biochemical marker for assessing the severity of disease.

Key words: HIE, Perinatal asphyxia, APGAR score, urine uric acid, urine creatinine.

Received: 26 February, 2019                            Revised: 29 March, 2019                  Accepted: 30 March, 2019

Corresponding Author: Dr. Beeregowda Y.C, Professor, Department of Paediatrics, Sri Devaraj Urs Medical College, SDUAHER, Kolar, Karnataka, India;

This article may be cited as: Suman K V, Y.C Beeregowda, K.N Shashidhar. Correlation of Urinary Uric Acid, Creatinine Ratio with the severity of Hypoxic Ischemic Encephalopathy.  J Adv Med Dent Scie Res 2019;7(5): 118-126.