Preterm is defined as a baby with a gestation of less than 37 completed weeks. In this study, serum calcium, phosphorus, ALP, creatinine, and electrolytes were measured in preterm babies. The present study comprised of 75 preterm babies of which 25 were of 28–30 weeks, 25 were of 30–32 weeks, and remaining 25 were of 34–36 weeks (controls) of gestational age. Serum calcium and
phosphorus levels were found to be significantly decreased, and serum ALP, creatinine, and electrolytes were found to be significantly increased (P < 0.001) at 28–30 weeks as compared to controls, but serum calcium and phosphorous levels were found to be insignificantly decreased, whereas serum ALP activities were found to be insignificantly increased at 28–30 weeks as compared to 30–32 weeks of gestational age in preterm babies. It can be concluded that high serum ALP activity and low serum calcium and phosphorus levels are associated with preterm babies. A significant difference in the mean values of these renal function parameters was also obtained, except for serum sodium and potassium.
Introduction
Perinatal asphyxia is one of the major causes of neonatal mortality and long-term morbidity. Although neonates with severe birth asphyxia are known to be at increased risk of early-onset hypocalcemia, the magnitude of the problem is not well documented. Magnesium plays a role in neuroprotection for neonates with hypoxic-ischemic encephalopathy (HIE). The objective of this study was to determine the prevalence of early-onset hypocalcemia and hypomagnesemia in severely asphyxiated neonates.
Materials and methods
This study was carried out on 75 newborns distributed as group I (50 asphyxiated neonates) and group II (25 healthy neonates). Serum calcium and serum magnesium was estimated within 24 hours after birth, followed by third and fifth day postbirth.
Results
Maximum number of cases (81.3%) were born by vaginal delivery. The mean value of serum calcium on days 1, 3, and 5 for group I was 7.004 ± 0.691, 7.482 ± 0.760, 8.184 ± 0.811 in contrast to group II: 8.788 ± 0.399, 9.476 ± 0.250, 9.992 ± 0.277 respectively. Whereas the mean value of serum magnesium for group I is reported as 1.545 ± 0.045, 1.496 ± 0.067, 1.556 ± 0.057 on days 1, 3, and 5, while that of group II was 1.518 ± 0.053, 1.597 ± 0.049, 1.66 ± 0.065 respectively. On HIE stage-wise comparison, abnormal calcium metabolism percentage increases with severity of asphyxia (46.6% abnormal in stage I, while 71.4% abnormal in stage III). Abnormal magnesium metabolism percentage also increases with severity of asphyxia (26.6% abnormal in stage I, while 71.4% abnormal in stage III) and this abnormality persists up to fifth day in stage III.
Conclusion
Birth asphyxia is the most common and important cause of preventable cerebral injury occurring in the neonatal period. Serum calcium and magnesium level plays exceptionally imperative role for escaping HIE and other induced complications.
How to cite this article
Bhimte B, Vamne A. Metabolic Derangement in Birth Asphyxia due to Cellular Injury with Reference to Mineral Metabolism in Different Stages of Hypoxic-ischemic Encephalopathy in Central India. Indian J Med Biochem 2017;21(2):86-90.
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