Title: Blood pH and urinary uric acid-creatinine ratio in newborns with asphyxia
Abstract: Background Asphyxia is one of the leading causes of death inthe world. Prematurity (28%), sepsis (26%), and asphyxia (23%)are the most common causes of death in newborns. In Indonesia,the newborn mortality incidence is 82 per 1,000 live births. BloodpH is a routine laboratory examination to diagnose newbornasphyxia, but it is preferrable to avoid such invasive procedures innewborns. An examination of urinary uric acid-creatinine (UA/Cr) ratio may be useful as an alternative method for diagnosisof asphyxia. Hypoxia causes anaerobic metabolism which willincrease the blood acidity, while creatinine will decline as a resultof incomplete renal function in newborns.Objective To assess for a possible correlation between blood pHand urinary UA/Cr ratio in newborn asphyxia.MethodsWe conducted an observational, cross-sectional study inProf. Dr. R. D. Kandou Hospital, Manado, North Sulawesi, fromNovember 2013 to April 2014. Subjects were full term newbornswith asphyxia. Blood pH and urinary UA/Cr ratio were comparedwith Pearson’s correlation test. Data was analyzed with SPSSversion 22 software and P values <0.05 were considered to bestatistically significant.Results Forty subjects met the inclusion criteria. Theirpredominant risk factor for asphyxia was fetal distress. Subjects’mean blood pH was 7.1 (SD 0.1) and mean urinary UA/Cr ratio was3.7 (SD 1.9). There was a moderate negative correlation betweenblood pH and urinary UA/Cr ratio (r= -0.55; P<0.001).Conclusion In newborns with asphyxia, lower blood pH iscorrelated with higher urinary UA/Cr ratio.