PREVALENCE OF ELECTROLYTE IMBALANCE IN NEONATES WITH BIRTH ASPHYXIA

Abstract

Perinatal hypoxia, often known as birth asphyxia, is the greatest cause of infant morbidity and death globally [1]. Hypoxia-ischemia damages several organs, often resulting in metabolic abnormalities and electrolyte imbalances in afflicted newborns [2, 7]. We performed cross-sectional research at a pediatric tertiary care hospital in Karachi, Pakistan, to investigate the incidence of severe electrolyte abnormalities (hyponatremia, hyperkalemia, hypocalcemia) and hypoglycemia among newborns suffering from birth asphyxia. Based on a projected 17.5% prevalence, a 95% confidence interval, and a 5% margin of error, n = 222 was determined. Between January and June 2024, we included 222 term newborns (gestational age ≥37 weeks) with birth asphyxia (Apgar score <7 at 5 minutes) and no significant congenital abnormalities. Demographic and clinical data were collected, and serum sodium, potassium, calcium, and glucose levels were measured between 24 and 72 hours of life. Parental permission was sought, as well as ethical clearance. Our group showed 22.5% hyponatremia, 9.0% hyperkalemia, 9.0% hypocalcemia, and 4.5% hypoglycemia. The average gestational age was 38.5±1.2 weeks, with 55% being male. Overall, 45% of newborns had at least one electrolyte imbalance. Figure 1 depicts the bar chart prevalence of each imbalance, whereas Figure 2 depicts the proportionate distribution of afflicted newborns. Hyponatremia was the most common (accounting for half of all imbalances), which is consistent with previous results [4, 5]. These results highlight the prevalence of electrolyte imbalances in asphyxiated newborns, particularly those with severe hypoxic-ischemic encephalopathy [6, 2]. Finally, comprehensive monitoring of sodium, potassium, calcium, and glucose is recommended in neonatal asphyxia to guide early therapy and enhance outcomes [7, 4].