The Urinary Uric Acid/Creatinine Ratio is An Adjuvant Marker for Perinatal Asphyxia

To assess the urinary uric acid/creatinine ratio (UA/Cr) in relation to Apgar score and cord blood gas analysis in identification of perinatal asphyxia and to define the cutoff values.

case control study.

The newborns admitted in the department of pediatrics and NICU of Mediciti Institute of Medical Science, Ghanpur, Medchal mandal, Telangana from May-July 2011 were enrolled.

The study was conducted on 31 (18 males, 13 females) controls and 18 (12males, 6 females) asphyxiated neonates.

5ml of arterial cord blood of newborn collected at the time of birth and spot urine samples were collected within 24-72 hours of life. Cord blood gas analysis were done immediately and Urinary uric acid was measured by modified Uricase method, urinary creatinine by modified kinetic Jaffe's reaction.

The mean urinary uric acid and creatinine ratio (2.58± 0.48 vs 1.89 ± 0.59) is significantly higher in Asphyxiated group than in the control group. The umbilical cord blood pH had significant positive correlation with 1^st minute Apgar score (r= 0.41, p=0.003), 5^th minute Apgar (r= 0.44, p=0.002), while urinary UA/Cr ratio had significant negative correlation with cord blood pH (r= -0.63, p=0.002). Urinary UA/Cr ratio with criterion of >2.43 had 80% sensitivity, 87.5% specificity with AUC of 0.84 (p=0.003) had a better predictive value.

Urinary UA/Cr ratio is easy, non-invasive, painless and economical adjuvant parameter with better predictive value for diagnosing perinatal asphyxia with simple diagnostic equipment.