Prevalence of electrolyte disturbances in perinatal asphyxia: a prospective study

Abstract

BackgroundBirth asphyxia is defined as the presence of hypoxia, hypercapnia, and acidosis leading the newborn to systemic disturbances probably electrolyte disturbance also. Knowledge of these electrolyte disturbances is very valuable as it can be an important parameter affecting perinatal morbidity, mortality and ongoing management.MethodsSerum sodium, potassium and ionized calcium of asphyxiated term newborn were sent within one hour of birth as per the inclusion criteria. Statistical comparison of mean values of different electrolytes between different groups of perinatal asphyxia was performed by ANOVA test for parametric data and significant data were further analyzed using post hoc test. Bivariate analysis was done to determine the correlations between Apgar score at 5 min and serum electrolytes. Pearson test was used to calculate the correlation coefficient. Box plot was used to show the median and quartile between serum electrolytes and Apgar score at 5 min.ResultThe mean values of sodium for mild, moderate and severe asphyxia were 135.52, 130.7 and 127.15 meq/l respectively. The values of potassium for mild, moderate and severe asphyxia were 4.96, 5.93 and 6.78 meq/l respectively. Similarly, the mean values of ionized calcium for mild, moderate and severe asphyxia were 1.07, 1.12 and 0.99 mmol/l respectively. The values of sodium and potassium among different severity of asphyxia were significantly different (p-value< 0.001). Significant positive correlation was found between serum sodium and Apgar score at 5 min. Significant negative correlation was present between serum potassium and Apgar score at 5 min.ConclusionThe degree of hyponatremia and hyperkalemia was directly proportional to the severity of birth asphyxia. So these electrolyte disturbances should always be kept in mind while managing cases of perinatal asphyxia and should be managed accordingly.

Clinico-Biochemical Correlation in Birth Asphyxia and Its Effects on Outcome

“…Other associated factors like breech presentation, macrosomia, and large size baby increase the severity of birth asphyxia. Previous studies in other parts of India and developing countries had similar findings [11,16]. Our study revealed that forceps/ventouse delivery may lead to severe birth asphyxia (p < 0.01), whereas LSCS is better and associated with HIE I (p < 0.001).…”

“…Thus, the sodium reabsorption capacity of the direct Coombs test (DCT) and more sodium loss in the urine causes hyponatremia. Further, birth asphyxia causes a syndrome of inappropriate antidiuretic hormone secretion (SIADH) and partial aldosterone resistance, leading to hyponatremia [ 16 ]. Hyponatremia leads to hypovolemia and further compromise of renal functions.…”

Correlation of Apgar score with serum glucose, calcium and electrolytes on the asphyxiated neonates

“…The result was in concordance with those of Basu et al 15 This lowered serum sodium (hyponatremia) which developed perinatally, proportionally contributes to the development of more severe asphyxia if not rectified immediately. 16 The serum potassium level among asphyxiated neonates was significantly higher than that of the controls. This increase in the serum potassium (hyperkaliemia) among the asphyxiated neonates showed a negative correlation with the Apgar score.…”

Report on advances for pediatricians in 2018: allergy, cardiology, critical care, endocrinology, hereditary metabolic diseases, gastroenterology, infectious diseases, neonatology, nutrition, respiratory tract disorders and surgery

“…Thakur et al have investigated electrolyte (sodium, potassium, calcium) disturbances in asphyxiated newborns of different severity [102]. They found that hyponatremia, hyperkalemia and hypocalcemia occurring in neonates with perinatal asphyxia may be responsible for increased morbidity and mortality and that hyponatremia and hyperkalemia are positively associated with the severity of birth asphyxia, thus confirming the data from Basu et al [103].…”