Utility of Urinary Uric Acid/Creatinine Ratio in Evaluating Birth Asphyxia: A Comparative Study with Cord Blood ABG and Apgar Scores
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https://doi.org/10.61705/k6qn1952Keywords:
Apgar scores, neonatal morbidity, urinary uric acid/creatinine ratio, cord blood ABGAbstract
Background: A major factor in the morbidity and death of newborns is birth asphyxia. An accurate and timely assessment is essential to a successful intervention. Traditional criteria with limited sensitivity and specificity include Apgar ratings and cord blood arterial blood gas (ABG).
The purpose of this study was to compare the diagnostic accuracy of the urine uric acid/creatinine ratio with cord blood ABG and Apgar ratings, and to assess it as a potential biomarker for birth hypoxia.
Methods: 300 newborns who were suspected of having hypoxia at delivery were the subjects of a prospective observational research. Within six hours following delivery, the levels of creatinine and urinary uric acid were assessed. Apgar scores and cord blood ABG were recorded simultaneously. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic's sensitivity, specificity, and accuracy.
Results: Cord blood ABG and Apgar ratings showed a strong association between the urine uric acid/creatinine ratio and the severity of newborn asphyxia. The cord blood ABG (AUC=0.87, 95% CI 0.82-0.92) and Apgar scores at 1 minute (AUC=0.82, 95% CI 0.76-0.88) and 5 minutes (AUC=0.84, 95% CI 0.79-0.89) were comparable to the urine uric acid/creatinine ratio's area under the ROC curve of 0.85 (95% CI 0.80-0.90).
In conclusion, there is potential for the urine uric acid/creatinine ratio to serve as a non-invasive, easily accessible biomarker for birth asphyxia, similar to established indicators. To confirm these results and investigate the underlying processes relating high uric acid levels to hypoxic-ischemic damage in newborns, more research is required.
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