Clinical and Biochemical Correlation in Perinatal Asphyxia and Its Association with Short Term Outcome

Abstract

Background: Perinatal asphyxia is a leading cause of neonatal morbidity and mortality worldwide. According to the World Health Organization, 3% of all infants in developing countries, that is, approximately 3.6 million experience moderate to severe birth asphyxia. Of these, around 23% (840,000) die, while a comparable number suffer from long – term neurological disabilities. Methods: This hospital–based, retrospective study included term neonates with perinatal asphyxia admitted in the Neonatal Intensive Care Unit of Dhulikhel hospital from 1st January 2021 till 31st December 2022. The data were collected from maternal and neonatal hospital records and then entered into SPSS version 25 for analysis, following ethical approval from the Institutional Review Committee. Results: Out of the total 123 term neonates enrolled, a male preponderance of 66.7% was observed. Based on HIE staging, 23.6% were HIE stage I, 69.1% were HIE stage II and 7.3% were HIE stage III. Seizures were present in 74.8% neonates; majority were of subtle type. Among the neonates enrolled, 9.76% expired. Hyponatremia, hyperkalemia, hypocalcemia, increased LDH level and hypoglycemia were some common biochemical changes noted. Seizures, respiratory distress, bradycardia, and hypothermia were found to be significantly associated with increasing severity of HIE (P<.05). There was also statistically significant difference in the outcome of babies depending upon the severity of HIE. Conclusion: Hypoxic–ischemic neonates with seizures, respiratory distress, advanced resuscitation needs, and electrolyte imbalances were more likely to have severe disease. Early detection and correction of biochemical abnormalities are crucial. Prompt resuscitation and metabolic support can reduce mortality and long–term sequelae.