ABSTRACT
In order to investigate purine metabolites as parameters of birth asphyxia, 16 acutely asphyxiated neonates representing the acute asphyxia group, and 18 neonates of mothers with severe pre-eclampsia representing the chronic hypoxia group were studied. The results were compared with those of 10 healthy neonates as control group. Cord blood samples were assessed for hypoxanthine and uric acid as purine metabolites as well for blood pH and lactate in all cases. Hypoxanthine was significantly increased [P < 0.001] in the acute asphyxia group but not in the chronic hypoxia group, and correlated significantly with blood lactate in the acute group [r = 0.894, P < 0.001]. Uric acid was significantly increased in the chronic hypoxia group [P < 0.001] but not in the acute asphyxia group. There was a significant negative correlation between uric acid and lactate in the acute group [r = - 0.546, P < 0.05] and a significant positive correlation in the chronic hypoxia group [r = 0.632, P < 0.01]. Cord blood lactate was significantly increased in both studied groups whereas pH was significantly decreased in the acute asphyxia group. Blood lactate correlated significantly with Apgar score in the acute group. There was no correlation between hypoxanthine or uric acid with either pH or Apgar score in both acute asphyxia and chronic hypoxia groups. The present study showed that cord blood hypoxanthine is increased in acute asphyxia whereas uric acid is increased in chronic hypoxia, however they are no better indicators for asphyxia than cord blood pH and lactate. Their importance depends on their predictive value with respect to brain damage which we recommend to be investigated through longitudinal follow-up studies