Decoding the Myth of Severity in HIE – A Study to Find Correlation of Serum Sodium and Calcium Levels with HIE Severity in Asphyxiated Neonates with Convulsion

Decoding the Myth of Severity in HIE

  • Sushama Sahoo Associate Professor, Department of Pediatrics, Malda Medical College and Hospital, Malda, West Bengal, India
  • Sanjib Mandal Senior Resident, Department of Pediatrics, Malda Medical College and Hospital, Malda, West Bengal, India https://orcid.org/0000-0002-3925-8661
Keywords: HIE, Neonatal seizure, Hyponatremia, Hypocalcemia

Abstract

Background: Hypoxic ischemic encephalopathy is a significant cause of neonatal morbidity and mortality and can lead to severe long term neurodeficits. There is a complex interaction of released neurotransmitters, altered electrolytes level and enzymatic activation. Without proper evaluation of biochemical changes, it is difficult to control its progression. The objective is to give an insight into correlation of severity with hypocalcemia and hyponatremia among HIE cases. Subjects and Methods: To conduct this cross sectional observational study serum sodium and calcium levels were measured in asphyxiated newborns who presented with seizure i.e HIE stage 2 and stage 3. Measured electrolytes levels were compared with severity of encephalopathy. Results: Results showed negative linear correlation of severity with both sodium and calcium levels but strength of association was more with sodium (r = -.631) than calcium (r = -.247). Also delay in presentation was more strongly associated with hyponatremia than hypocalcemia. Conclusion: Biochemical disturbances are very common in newborn with perinatal asphyxia. Among those who are presenting with seizures, hyponatremia is possibly more detrimental than hypocalcemia.

Downloads

Download data is not yet available.

References

Moshiro R, Mdoe P, Perlman JM. A Global View of Neonatal Asphyxia and Resuscitation. Front Pediatr. 2019;7:489. ;Avail- able from: https://dx.doi.org/10.3389/fped.2019.00489.

Lai MC, Yang SN. Perinatal hypoxic-ischemic encephalopathy. J Biomed Biotechnol. 2011;2011:609813. ;Available from: https://dx.doi.org/10.1155/2011/609813.

Allen KA, Brandon DH. Hypoxic Ischemic Encephalopa- thy: Pathophysiology and Experimental Treatments. Newborn Infant Nurs Rev. 2011;11(3):125-133. ;Available from: https://dx.doi.org/10.1053/j.nainr.2011.07.004.

Moayedi AM, Zakeri S, Moayedi F. Neonatal Seizure: Etiology and Type. Iran J Child Neurol. 2008;2(2):23–26. Available from: https://doi.org/10.22037/ijcn.v2i2.458.

Robertson CM, Perlman M. Follow-up of the term infant after hypoxic-ischemic encephalopathy. Paediatr Child Health 2006;11(5):278-282.;.

Thakur J, Bhatta NK, Singh RR, Poudel P, Lamsal M, Shakya A. Prevalence of electrolyte disturbances in perinatal asphyxia:a prospective study. Ital J Pediatr. 2018;44(1):56. Available from: https://doi.org/10.1186/s13052-018-0496-7.

Gupta BD, Sharma P, Bagla J, Parakh M, Soni JP. Renal Failure in Asphyxiated Neonates. Indian Pediatrics. 2005;42:928–934.

Moen V, Irestedt L. Hyponatremia in Birth Asphyxia—Cause or Effect? Indian J Pediatr. 2010;77(9):1049–1050. Available from: https://dx.doi.org/10.1007/s12098-010-0161-7.

Madhusudhan K, Suresh N, Babu T, Rao J, Kumar S. Study of biochemical abnormalities in neonatal seizures with special reference to hyponatremia. Int J Contemp Pediatr. 2016;3(3):730–734. Available from: https://dx.doi.org/10.18203/2349-3291.ijcp20162172.

Pasi R, Roy B, Ravi KS, Chacham S. Profile of Neonatal Seizures and its Correlation with Serum Sodium Levels: A Prospective Cross-sectional Study. J Clin Diagn Res. 2019;13(4):4–07. Available from: https://dx.doi.org/10.7860/jcdr/2019/40485.12760.

Vayalthrikkovil S, Bashir R, Espinoza M, Irvine L, Scott JN, Mohammad K. Serum calcium derangements in neonates with moderate to severe hypoxic ischemic encephalopathy and the impact of therapeutic hypothermia: a cohort study. J Matern- Fetal Neonatal Med. 2020;33(6):935–940. Available from: https://dx.doi.org/10.1080/14767058.2018.1510911.

Thakur J, Bhatta NK, Singh RR, Poudel P, Lamsal M, Shakya A. Prevalence of electrolyte disturbances in perinatal asphyxia: a prospective study. Ital J Pediatr. 2018;44(1):56. ;Available from: https://dx.doi.org/10.1186/s13052-018-0496-7.

Basu P, Som S, Das H, Choudhuri N. Electrolyte status in birth asphyxia. Indian J Pediatr. 2010;77(3):259–262. Available from: https://doi.org/10.1007/s12098-010-0034-0.

Gagandeep V, S VP. Syndrome of inappropriate antidiuretic hormone secretion in neonates with birth asphyxia at tertiary care centre. Int J Contemp Pediatr. 2019;6(6):2549. Available from: https://dx.doi.org/10.18203/2349-3291.ijcp20194732.

D SK, M T, K. Electrolyte abnormalities in asphyxiated newborns. Int J Contemp Pediatr. 2018;5(3):1036. Available from: https://dx.doi.org/10.18203/2349-3291.ijcp20181537.

Vamne A, Bhimte B. Metabolic Derangement in Birth Asphyxia due to Cellular Injury with Reference to Min- eral Metabolism in Different Stages of Hypoxic-ischemic Encephalopathy in Central India. Indian J Med Biochem. 2017;21(2):86–90. Available from: https://dx.doi.org/10.5005/jp-journals-10054-0027.

Published
2021-03-30
How to Cite
Sushama Sahoo, & Sanjib Mandal. (2021). Decoding the Myth of Severity in HIE – A Study to Find Correlation of Serum Sodium and Calcium Levels with HIE Severity in Asphyxiated Neonates with Convulsion. Asian Journal of Clinical Pediatrics and Neonatology, 9(1), 32- 35. Retrieved from https://aijournals.com/index.php/ajcpn/article/view/1918
Section
Original Article