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[Anion gap in perinatal asphyxia].

A Vargas-Origel1, I Murillo Rangel

  • 1Unidad de Investigación en Epidemiología Clínica, Hospital de Gineco-Pediatría No. 48, Instituto Mexicano del Seguro Social León, Gto.

Ginecologia Y Obstetricia De Mexico
|June 11, 1999
PubMed
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The anion gap (AG) shows moderate usefulness in diagnosing perinatal asphyxia (PA), with 81% sensitivity but only 52% specificity. While AG correlates with bicarbonate levels, it does not strongly predict newborn outcomes in PA cases.

Area of Science:

  • Neonatal Medicine
  • Clinical Chemistry
  • Biochemistry

Background:

  • Perinatal asphyxia (PA) is a serious condition requiring accurate diagnosis.
  • The anion gap (AG) is a biochemical parameter that may aid in diagnosing metabolic disturbances.

Purpose of the Study:

  • To evaluate the diagnostic utility of the anion gap (AG) for perinatal asphyxia (PA).
  • To assess the relationship between AG, umbilical cord pH, and neonatal outcomes.

Main Methods:

  • Studied 62 infants, measuring umbilical artery blood gases and serum electrolytes within 15 minutes of birth.
  • Calculated AG using the formula: (Na + K) - (Cl + HCO3).
  • Grouped infants by pH (PA group ≤ 7.10, control group > 7.10) and by survival status.

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Main Results:

  • The PA group showed significantly lower Apgar scores and pH, and a higher AG (23.4 mEq/L) compared to the control group (13.9 mEq/L).
  • An AG cutoff of 20 mEq/L yielded 81% sensitivity and 52% specificity for PA diagnosis.
  • No significant difference in AG was observed between survivors and non-survivors, though survivors had higher birthweight, pH, and bicarbonate levels.

Conclusions:

  • The anion gap demonstrates moderate sensitivity but limited specificity for diagnosing perinatal asphyxia.
  • AG shows a positive correlation with bicarbonate, sodium, and chloride levels.
  • AG is not a reliable predictor of neonatal outcomes in cases of perinatal asphyxia.