Association of Cord Blood Glucose and Electrolyte Levels With Birth Asphyxia And Hie Severity in Late-Preterm and Term Neonates: A Hospital-Based Cross-Sectional Study

Abstract

Background: Birth asphyxia may be accompanied by metabolic disturbances associated with hypoxic-ischaemic injury. This study compared cord blood glucose and electrolyte concentrations between asphyxiated and non-asphyxiated neonates and assessed their association with hypoxic-ischaemic encephalopathy (HIE) severity.

Methods: This hospital-based cross-sectional study included 96 inborn neonates with gestational ages greater than 34 and up to 42 completed weeks, comprising 48 neonates with birth asphyxia and 48 controls. Approximately 2 mL of umbilical venous cord blood was collected immediately after delivery. Glucose, calcium, sodium and potassium were measured using standard laboratory methods. HIE severity among cases was graded using Sarnat staging. Between-group comparisons and correlations with HIE severity were analysed, with p≤0.05 considered statistically significant.

Results: Compared with controls, asphyxiated neonates had lower mean glucose (48.6±12.4 vs 69.3±11.8 mg/dL; p<0.001), sodium (131.8±5.6 vs 135.2±4.3 mEq/L; p=0.002) and calcium (7.9±0.8 vs 9.1±0.7 mg/dL; p<0.001), whereas potassium was higher (5.8±0.9 vs 4.7±0.7 mEq/L; p<0.001). Reported frequencies of severe hypoglycaemia, hyponatraemia, hyperkalaemia and hypocalcaemia were 26.7%, 46.7%, 53.3% and 50.0%, respectively. Increasing HIE severity was associated with lower glucose (r=−0.62), sodium (r=−0.41) and calcium (r=−0.48), and higher potassium (r=+0.53); all reported associations were statistically significant.

Conclusion: Birth asphyxia was associated with significant differences in cord blood glucose and electrolyte concentrations. These biochemical parameters were also associated with HIE severity and may provide supportive information alongside clinical assessment. Further studies are required to validate their clinical utility.