Razi Journal of Medical Sciences

Background: Prenatal asphyxia is one of the important causes of morbidity and mortality in neonates. Several studies tried to find a marker for early diagnosis of prenatal asphyxia. This study  aimed to examine the diagnostic value of urinary uric acid to creatinine (UA/Cr) ratio in perinatal asphyxia.

Methods: In this study, 48 term infants with prenatal asphyxia and 48 healthy neonates were compared in terms of uric acid to creatinine ratio in urine samples from the first 24 hours of birth. Demographic data including sex, birth weight, gestational age, and mode of delivery were also recorded.

Results: The mean uric acid to creatinine ratio was significantly higher in infants with asphyxia than the control group (respectively, 2.1 ± 1.00 vs. 0.8 ± 0.20  p= 0.0001). The urine UA / Cr ratio was also positively and significantly associated with the severity of asphyxia (p= 0.0001). Urine ​​UA / Cr values were not related to neonatal sex, gestational age, and birth weight. However, the ratio was higher in emergency c-section (2± 0.90)  compared with elective caesarean section (1.3 ± 0.90) and vaginal (1.26 ± 0.90). Cut-off point equal to 1.20 appears to be the most appropriate cutoff for urine UA / Cr ratio with 87% sensitivity, 91% specificity, and accuracy of the 5.89%, in the diagnosis of perinatal asphyxia in term infants.

Conclusions: Urine UA / Cr ratio can be introduced as a marker for early, easy and cost effective detection of perinatal asphyxia.