ABSTRACT
Objective To investigate the relationship between serum plasma brain natriuretic peptide ( BNP ) levels and myocardial injury in neoborns after asphyxia. Methods Neoborns who were admitted to Department of neonatology, Zhongnan Hospital, Wuhan University from December 2012 to December 2013 within 3 days after birth were considered. According to the number organized in chronological order every other case, newborns with neonatal asphyxia were assigned to observation group. The observation group were further divided into myocardial injury subgroup and non-cardiac injury subgroup according to the diagnostic criteria of myocardial injury. Newborns without neonatal asphyxia or neonatal cardiovascular diseases were assigned to control group. Exclusion criteria for control group were electrolyte disturbance, liver and kidney dysfunction. Blood sample was drawn from patients within 2 hours of admission to hospital and again on day 14. Serum BNP , creatine kinase isoenzyme ( CK-MB) , serum sodium and calcium were detected for further analysis. Results In 107 cases with neonatal asphyxia, 77 infants who had complete clinical records were selected as observation group, of which 36 met the diagnostic criteria of myocardial injury and assigned to myocardial injury subgroup. Non-cardiac injury subgroup consisted of the rest 41 cases in observation group. Twenty-two cases were enrolled to control group. Within 2 hours after admission, the serum BNP level of myocardial injury subgroup were significantly higher than those of the non-cardiac injury subgroup and the control group ( 2. 35 ± 0. 44 , 2. 12±0. 64, 1. 88±0. 27, log transformed, respectively, P＜0. 05). The BNP level of non-cardiac injury subgroup were also significantly higher than those of the control group. Serum BNP and CK-MB levels of observation group were positively correlated (r=0. 212,P=0. 030). After treatment, serum BNP level of myocardial injury subgroup at 14 days after admission decreased significantly, compared to the level at 2 hours within admission (P＜0. 05). When the cutoff value for infants with myocardial injury was 108. 05 pg/mL, the area under the ROC curve was 0. 753, with a sensitivity of 75. 0％ and a specificity of 64. 5％, positive predictive value was 56. 4％ and negative predictive value was 72. 3％. Conclusions Serum BNP level can reflect myocardial injury in neonates with asphyxia and can guide clinical treatment.
ABSTRACT
A asfixia perinatal é caracterizada por acidose metabólica ou mista devido à falta de oxigenação e perfusão sanguínea nos tecidos, sendo esta uma das maiores causas de óbitos neonatais e de sequelas neurológicas em recém-nascidos. O objetivo deste trabalho é conhecer a prevalência de asfixia perinatal em recém-nascidos, caracterizando as variáveis maternas, fetais e do parto e quantificando a ocorrência dos óbitos neonatais por asfixia perinatal no Hospital Geral Prado Valadares (HGPV), no município de Jequié (BA). Metodologicamente, trata-se de estudo descritivo, seccional para levantamento da prevalênciade asfixia perinatal em recém-nascidos no HGPV, no período de janeiro a junho de 2007. Osdados foram obtidos através das declarações dos nascidos vivos dos prontuários dos neonatos.Os resultados apontam que a prevalência da asfixia perinatal foi de 4,21% entre recém nascidos; destes, 62,3% a termo, e peso ao nascer (56,6%) entre 2.500 a 3.999g. Para as variáveis maternas 90,8% eram solteiras, com média de idade de 22,63 anos (± 6,295), coma ocupação do lar (82,2%), e menos de 8 anos de estudo (61,8%). Destas mães, 53,9% eramprimíparas, 76,3% tiveram parto vaginal e 50,0% realizaram de 4 a 6 consultas pré-natais.Concluiu-se que a alta prevalência encontrada no estudo aponta a necessidade de atençãopara os nascimentos no HGPV.
Perinatal asphyxia is an affection characterized by metabolic and mixed acidosis due to lack of oxygenation and blood perfusion on tissues, being one of the higher causes of neonatal deaths and neurological sequela e in infants. The objective of this study is to learn the prevalence of perinatal asphyxia in newborns, characterizing maternal, fetal and delivery variables, quantifying the occurrence of neonatal deaths by perinatal asphyxia in Prado Valadares General Hospital. Methodologically, it is a descriptive and cross-sectional study, aimed at finding out the prevalence of perinatal asphyxia in infants born at Prado Valadares General Hospital (PVGH) in the city of Jequié (BA), from January to June 2007. Data about mother, infant and delivery were obtained from birth certificates of live infants records. Results show that the prevalence of perinatal asphyxia was 4.21 cases of asphyxia among infants by 100 births, being term infantsthose with adequate weight (between 2,500 and 3,999g) and with no sex predomination. The mothers have mean age of 22.63 years, singles, housekeepers, education inferior to 8 years ofstudy, who had from 4 to 6 prenatal consultations, being primiparae with vaginal delivery. Of the 76 cases of asphyxia, 6 passed away which represents 7.9%. Concluded that the prevalence of perinatal asphyxia found in the study was high demonstrating the necessity attention to the births in PVGH.