Basic biochemical and hematological parameters in perinatal asphyxia and their correlation with hypoxic ischemic encephalopathy

Munteanu,Andrei Ioan; Manea,Aniko-Maria; Jinca,Cristian Marius; Boia,Marioara

doi:10.3892/etm.2021.9690

Basic biochemical and hematological parameters in perinatal asphyxia and their correlation with hypoxic ischemic encephalopathy

Authors:
- Andrei Ioan Munteanu
- Aniko-Maria Manea
- Cristian Marius Jinca
- Marioara Boia
View Affiliations

Affiliations: Department of Puericulture and Neonatology, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara , Romania, Department of Pediatrics, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara , Romania
Published online on: January 25, 2021 https://doi.org/10.3892/etm.2021.9690
Article Number: 259

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Perinatal hypoxic‑ischemic encephalopathy (HIE) represents a major cause of neonatal death or long‑term disability. Inflammation plays an important role in mediating brain damage induced by neonatal hypoxic‑ischemic encephalopathy. The mechanisms underlying the inflammatory response in hypoxia and ischemia are complex and are still being extensively researched. The objective of this study was to determine the predictive value of peak lactate dehydrogenase (LDH), C‑reactive protein (CRP), procalcitonin (PCT) and of the evolution of leukocytes, neutrophils and lymphocytes in the first 96 h after birth for the grade of encephalopathy and neurodevelopmental outcome in newborns with HIE. In order to reveal this relationship we used comparisons between the above mention parameters. The observed hematological changes were nonspecific. The vast majority of the 78 newborns included in the study had PCT values above normal in the first 24 h, contrasting with CRP values that were positive in only 15.8% of the patients. A total of 76.9% of the patients had LDH values higher than the upper limit of normal values. The mean LDH values in patients with an unfavorable prognosis were 1,235 U/l. We can conclude that LDH is a good predictor of HIE in the first 12/24 h after birth.

View Figures

View References

1	Douglas-Escobar M and Weiss MD: Hypoxic-Ischemic Encephalopathy A review for the Clinician. JAMA Pediatr. 169:397–403. 2015.PubMed/NCBI View Article : Google Scholar
2	Chaparro-Huerta V, Flores-Soto ME, Merin Sigala ME, Barrera de León JC, Lemus-Varela M de L, Torres-Mendoza BM de G and Beas-Zárate C: Proinflammatory cytokines, enolase and S-100 as early biochemical indicators of hypoxic-ischemic encephalopathy following perinatal asphyxia in newborns. Pediatr Neonatol. 58:70–76. 2017.PubMed/NCBI View Article : Google Scholar
3	Allen KA and Brandon DH: Hypoxic ischemic encephalopathy: Pathophysiology and experimental treatments. Newborn Infant Nurs Rev. 11:125–133. 2011.PubMed/NCBI View Article : Google Scholar
4	Serban D, Anton E, Chirita R, Bild V, Ciobica A, Alexinschi O, Arcan O, Popescu R, Paduraru L and Timofte D: Current aspects of the interactions between dementia, the brain renin-angiotensin system and oxidative stress. Arch Biol Sci. 67:903–907. 2015.
5	Yıldız EP, Ekici B and Tatlı B: Neonatal hypoxic ischemic encephalopathy: An update on disease pathogenesis and treatment. Expert Rev Neurother. 17:449–459. 2017.PubMed/NCBI View Article : Google Scholar
6	Karlsson M, Wiberg-Itzel E, Chakkarapani E, Blennow M, Winbladh B and Thoresen M: Lactate dehydrogenase predicts hypoxic ischaemic encephalopathy in newborn infants: A preliminary study. Acta Paediatr. 99:1139–1144. 2010.PubMed/NCBI View Article : Google Scholar
7	Hayes BC, Doherty E, Grehan A, Madigan C, McGarvey C, Mulavany S, Geary M, Matthews TG and King MD: Are serum markers of liver and muscle injury useful in neonatal hypoxic-ischemic encephalopathy? J Neonatal Perinatal Med. 5:305–310. 2012.
8	Reddy S, Dutta S and Narang A: Evaluation of lactate dehydrogenase, creatine kinase and hepatic enzymes for the retrospective diagnosis of perinatal asphyxia among sick neonates. Indian Pediatr. 45:144–147. 2008.PubMed/NCBI
9	Jahan R, Khanam A, Masood A and Rehman R: Diagnostic accuracy of lactate dehydrogenase for diagnosis of perinatal asphyxia in neonates with non-reactive CTG. Pak J Med Heal Sci. 13:458–460. 2019.
10	Yilmaz G, Arumugam TV, Stokes KY and Granger DN: Role of T lymphocytes and interferon-gamma in ischemic stroke. Circulation. 113:2105–2112. 2006.PubMed/NCBI View Article : Google Scholar
11	Zarbock A and Ley K: Mechanisms and consequences of neutrophil interaction with the endothelium. Am J Pathol. 172:1–7. 2008.PubMed/NCBI View Article : Google Scholar
12	Liu F and Mccullough LD: Inflammatory responses in hypoxic ischemic encephalopathy. Acta Pharmacol Sin. 34:1121–1130. 2013.PubMed/NCBI View Article : Google Scholar
13	Christensen RD, Baer VL, Gordon PV, Henry E, Whitaker C, Andres RL and Bennett ST: Reference ranges for lymphocyte counts of neonates: Associations between abnormal counts and outcomes. Pediatrics. 129:e1165–e1172. 2012.PubMed/NCBI View Article : Google Scholar
14	Morkos AA, Hopper AO, Deming DD, Yellon SM, Wycliffe N, Ashwal S, Sowers LC, Peverini RL and Angeles DM: Elevated total peripheral leukocyte count may identify risk for neurological disability in asphyxiated term neonates. J Perinatol. 27:365–370. 2007.PubMed/NCBI View Article : Google Scholar
15	Lelubre C, Bouzat P, Crippa IA and Taccone FS: Anemia management after acute brain injury. Crit Care. 20(152)2016.PubMed/NCBI View Article : Google Scholar
16	Kalteren WS, Ter Horst HJ, den Heijer AE, de Vetten L, Kooi EMW and Bos AF: Perinatal anemia is associated with neonatal and neurodevelopmental outcomes in infants with moderate to severe perinatal asphyxia. Neonatology. 114:315–322. 2018.PubMed/NCBI View Article : Google Scholar
17	Alsulaimani AA, Abuelsaad AS and Mohamed NM: Inflammatory cytokines in neonatal hypoxic ischemic encephalopathy and their correlation with brain marker S100 protein: A case control study in Saudi Arabia. J Clin Cell Immunol. 6:1–8. 2015.
18	Saito J, Shibasaki J, Shimokaze T, Kishigami M, Ohyama M, Hoshino R, Toyoshima K and Itani Y: Temporal relationship between serum levels of interleukin-6 and C-reactive protein in therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy. Am J Perinatol. 33:1401–1406. 2016.PubMed/NCBI View Article : Google Scholar
19	Shah V, Beyene J, Shah P and Perlman M: Association between hematologic findings and brain injury due to neonatal hypoxic-ischemic encephalopathy. Am J Perinatol. 26:295–302. 2009.PubMed/NCBI View Article : Google Scholar
20	Vandana V, Amit V, Meena V, Anuradha B, Vivek B, Deepak V and Salone MR: Study of basic biochemical and haematological parameters in perinatal asphyxia and its correlation with hypoxic ischemic encephalopathy (HIE) Staging. J Adv Res Biol Sci. 3:79–85. 2011.
21	Dina P and Muraskas JK: Hematologic changes in newborns with neonatal encephalopathy. Neoreviews. 19:e29–e33. 2018.
22	Povroznik JM, Engler-Chiurazzi EB, Nanavati T and Pergami P: Absolute lymphocyte and neutrophil counts in neonatal ischemic brain injury. SAGE Open Med. 6(2050312117752613)2018.PubMed/NCBI View Article : Google Scholar
23	Yum SK, Moon CJ, Youn YA and Sung IK: Changes in lactate dehydrogenase are associated with central gray matter lesions in newborns with hypoxic-ischemic encephalopathy. J Matern Neonatal Med. 30:1177–1181. 2017.PubMed/NCBI View Article : Google Scholar
24	Mehta A, Chawla D, Kaur J, Mahajan V and Guglani V: Salivary lactate dehydrogenase levels can provide early diagnosis of hypoxic-ischaemic encephalopathy in neonates with birth asphyxia. Acta Paediatr. 104:e236–e240. 2015.PubMed/NCBI View Article : Google Scholar