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Updated: Oct 15, 2026
Biochemical Measurement of Neonatal Hypoxia
Published on: August 24, 2011
Serum total magnesium and ionized calcium concentrations in asphyxiated term newborn infants with hypoxic-ischaemic
1Department of Paediatrics, Children's Hospital of University of Tartu, Estonia. pilvi@cut.ee
Insights
Electrolyte imbalances, including magnesium, calcium, and sodium, are common in infants with hypoxic-ischaemic encephalopathy (HIE). These derangements are linked to poor outcomes, highlighting the need for routine electrolyte monitoring.
Area of Science:
- Neonatalogy
- Biochemistry
- Pediatric Neurology
Background:
- Hypoxic-ischaemic encephalopathy (HIE) is a serious condition in newborns.
- Electrolyte balance is crucial for neonatal health.
- Previous research has explored various biomarkers in HIE, but electrolyte derangements require further investigation.
Purpose of the Study:
- To investigate serum electrolyte concentrations (magnesium, calcium, sodium, potassium) in asphyxiated term infants.
- To correlate electrolyte abnormalities with the severity of HIE and clinical outcomes.
- To assess the diagnostic and prognostic value of routine electrolyte measurements.
Main Methods:
- Colorimetric assessment of serum electrolytes in umbilical cord blood and venous blood.
- Study included 46 asphyxiated and 35 healthy term infants.
- Electrolyte levels were analyzed in relation to HIE severity and clinical outcomes at 24-48 hours of life.
Main Results:
- Asphyxiated infants showed altered total magnesium levels compared to controls, with higher levels in mild HIE and lower in severe HIE.
- By 24-48 hours, infants with severe HIE exhibited increased serum magnesium.
- Electrolyte derangements (hypermagnesemia, hyponatremia, hypocalcemia) were frequent in asphyxiated infants, with at least two abnormalities significantly associated with poor outcomes.
Conclusions:
- Magnesium, calcium, and sodium derangements are common in asphyxiated infants.
- These electrolyte abnormalities are significantly associated with poor clinical outcomes.
- Routine determination of magnesium, alongside other electrolytes, is recommended for improved outcome prediction in HIE.
Unlabelled:
Total magnesium, ionized calcium, potassium and sodium concentrations in mixed umbilical cord blood and venous blood serum at a median (min.-max.) age of 33 h (24-48 h) were assessed colorimetrically in 46 asphyxiated and 35 healthy term infants. Asphyxiated infants without any signs or with signs of mild hypoxic-ischaemic encephalopathy (HIE) had significantly higher, and infants with severe HIE lower umbilical cord blood serum total magnesium (mean (95%CI) 0.81 (0.75-0.87) mmol/l and 0.64 (0.47-0.87) mmol/l, respectively, p < 0.05) compared with the control group (0.72 (0.69-0.76)mmol/l). An increase in serum total magnesium in spite of normalized acid-base status in asphyxiated infants suffering from severe HIE compared with the control group infants was found by the second day of life (0.97 (0.87-1.07) mmol/l and 0.86 (0.81-0.9) mmol/l, respectively, p < 0.05). At the age of 24-48 h hypermagnesaemia (>2 SD) was discovered in 36%, hyponatremia (<2 SD) in 38%, and hypocalcaemia (<2 SD) in 23% of asphyxiated infants. Derangements (>2 SD) in at least two electrolytes by the second day of life were significantly associated with poor outcome.
Conclusions:
Magnesium, calcium and sodium derangements are a frequent finding in asphyxiated infants, and these abnormalities are significantly associated with poor outcome. For a better outcome prediction, the routine determination of magnesium in addition to other electrolytes in asphyxiated infants is recommended.
