Evaluation of the Association of Laboratory Tests Associated with Mortality in Term Neonates with Hypoxic-Ischemic Encephalopathy

Abstract

Objective: The evaluation of the relationships between the mortality and early period laboratory tests in the term infants diagnosed as hypoxic ischemic encephalopathy (HIE).Material and Methods: The newborns diagnosed as HIE between January 2004 and December 2008 were divided into two groups as the living and non-surviving groups. The two groups were evaluated prospectively.Results: Thirty two infants were included in the study. According to the Sarnat&Sarnat classification, 9 (28.1%), 14 (43.8%) and 9 infants (28.1%) were in stage 1, 2 and 3, respectively. Eight (25%) infants died. In the correlation evaluation of risk factors; lack of-follow-up at the antenatal period (r²=0.35) and having convulsions (r²=0.50) were positively associated with Sarnat stage. A positive relationship between Sarnat stage and the mortality rate was also determined (r²=0.57). CK-MB was strongly (r²=0.74), troponin-I moderately (r²=0.44), and pH weakly (r²=0.27) associated with mortality. In predicting mortality, the sensitivity and specificity for CK-MB was 100% and 91.6%, for Troponin I 100% and 70.8% and for pH 75% and 87.5%, respectively.Conclusion: This study demonstrates that in HIE, the relationship between the early period mortality rate and CK- MB values are strong, whereas for troponin-I and pH there is a moderate and weak association respectively.

Keywords

• Hypoxic-ischemic encephalopathy
• mortality
• CK-MB
• troponin I
• newborn