Blood pH and urinary uric acid-creatinine ratio in newborns with asphyxia
Abstract: Asphyxia is one of
the leading causes of death in the world. Prematurity (28%), sepsis (26%), and
asphyxia (23%) are the most common causes of death in newborns. In Indonesia, the
newborn mortality incidence is 82 per 1,000 live births. Blood pH is a routine
laboratory examination to diagnose newborn asphyxia, but it is preferrable to
avoid such invasive procedures in newborns. An examination of urinary uric
acid-creatinine (UA/Cr) ratio may be useful as an alternative method for
diagnosis of asphyxia. Hypoxia causes anaerobic metabolism which will increase
the blood acidity, while creatinine will decline as a result of incomplete
renal function in newborns. Objective To assess for a possible correlation
between blood pH and urinary UA/Cr ratio in newborn asphyxia.
Methods We conducted an observational, cross-sectional study in Prof. Dr.
R. D. Kandou Hospital, Manado, North Sulawesi, from November 2013 to April
2014. Subjects were full term newborns with asphyxia. Blood pH and urinary
UA/Cr ratio were compared with Pearson’s correlation test. Data was analyzed
with SPSS version 22 software and P values <0.05 were considered to be statistically
significant.
Results Forty subjects met the inclusion criteria. Their predominant risk
factor for asphyxia was fetal distress. Subjects’ mean blood pH was 7.1 (SD
0.1) and mean urinary UA/Cr ratio was 3.7 (SD 1.9). There was a moderate
negative correlation between blood pH and urinary UA/Cr ratio (r= -0.55;
P<0.001). Conclusion In newborns with asphyxia, lower blood pH is correlated
with higher urinary UA/Cr ratio. [Paediatr Indones.
Author: Sally Palit, Rocky
Wilar, Ari L. Runtunuwu, Julius H. Lolombulan
Journal Code: jpkedokterangg150281