Ischemia-modified albumin (IMA): could it be useful to predict perinatal asphyxia?

Perinatal asphyxia is a significant cause of perinatal morbidity and mortality worldwide. It is estimated that around 23% of all newborn deaths are caused by birth asphyxia. Each year, between four and nine million newborns develop birth asphyxia worldwide, according to the World Health Organization (WHO). Therefore, despite major advances in monitoring and knowledge of fetal and neonatal physiology and development, perinatal asphyxia remains a serious condition that causes significant mortality and long-term morbidity. However, to date no single marker of perinatal asphyxia has shown good predictive efficacy in prediction and early diagnosis of perinatal asphyxia. On the other hand, ischemia-modified albumin (IMA) is a new biomarker in identification of myocardial ischemia of myocardial necrosis. IMA may also increase in the ischemia of liver, brain, kidney and bowel. Ischemia of these organs may also seen in perinatal asphyxia as well. Reactive oxygen species, produced during ischaemia/reperfusion which is essential steps of perinatal asphyxia, may generate the highly reactive hydroxyl radicals. These hydroxyl radicals modify the albumin and transforms it into IMA. Therefore, IMA might be useful for the prediction and diagnosis of perinatal asphyxia. Further studies are urgently needed to determine the role of IMA in the prediction of perinatal asphyxia.