Serum Creatine Kinase Muscle-Brain Fraction (CK-MB) and Lactate Dehydrogenase (LDH) as Markers of Perinatal Asphyxia in Term Neonates

Abstract

Background: The enzymes CK-MB & LDH are used as potential predictors of timing and grade of HIE in newborns with perinatal asphyxia.
 Objectives: To differentiate HIE neonates from non-HIE ones on the basis of significant rise of LDH & CK-MB.
 Methodology: Prospective cross-sectional analytical study. Among 164 newborns, 82 comprising the cases and 82 neonates comprising the controls met the inclusion and exclusion criteria. The umbilical cord blood samples for CK-MB and LDH was drawn and sent for analysis. A serum CK-MB value >92.6 U/L and LDH value >580 U/L was taken as the cut-off level. Descriptive statistical analyses were done to find the significance between two groups. ROC Curve analysis was performed to find the diagnostic performance of CK-MB and LDH.
 Results: Out of total 164 neonates studied, 18.3% had moderate HIE & 11%had severe HIE while 56.1%had No HIE. Seventy-two newborns were found to have LDH levels >580 U/L out of which 71 were in case group and 1 was in control group. Among the 164 neonates studied, 7.9% from case group were found to have CK-MB levels >92.6 U/L. Both the results of LDH & CK-MB levels were very significant with P value <0.001. Area under ROC (Receiving operating Characteristic) value of LDH when compared to CK-MB is (0.978 vs. 0.731).
 Conclusion: Estimation of CK-MB and LDH enzymes can help to distinguish asphyxiated from non-asphyxiated term neonates when correlating with their history and clinical features.

Foetal Intrapartum Compromise at Term: Could COVID-19 Infection Be Involved? A Case Report

“…Another condition that worsened the placenta–foetal gas exchange was uterine hypercontractility, which occurred suddenly after a normally evolving labour. The literature is consistent in demonstrating that uterine tachysystole gives no time for placental reperfusion and foetal recovery [ 13 ]. There is a lack of evidence as to whether COVID-19 infections can also affect the uterine muscle and interfere with normal contractility in labour.…”

“…We used blood lactate dehydrogenase (LDH) [ 11 , 12 ], creatine-kinase (CK) and creatine-kinase muscle-brain (CK-MB) [ 13 ] as markers of tissue hypoxia. LDH was increased during the first 3 days of life, but the values were under the cut-off value for risk of severe prognosis (1054 U/L) [ 12 ].…”

Role of Creatine Kinase MB in Diagnosis of Myocardial Injury after Neonatal Hypoxia-Ischemia

“…Other studies found that CK-MB was not helpful in predicting myocardial injury in a group of infants with neonatal hypoxic ischemia, and levels of CK-MB do not help distinguish between asphyxiated newborns and normal infants. Therefore, CK-MB may not be helpful in identifying infants with neonatal hypoxic ischemia who have cardiovascular compromise but may be more useful as part of a predictive model for poor outcome following neonatal hypoxic ischemia (7,8) .…”