RESUMO
This study was performed at Al Ansar Hospital in Jeddah during the period from September 2004 to September 2005. Our objective was to identify whether moderate or severe hypoxic-ischemic encephalopathy [HIE] after birth asphyxia can be predicted by measuring serum protein S-100 or serum ionized calcium concentrations soon after birth. The study included two groups, asphyxia group and control group. The asphyxiated group included 21 full term asphyxiated newborn infants, who were subdivided clinically into: 10 asphyxiated newborns with no HIE, 5 asphyxiated newborns with mild HIE, 3 asphyxiated newborns with moderate HIE, and 3 newborns with severe HIE. The control group included 10 full term healthy normal newborn infants. Neurological examinations were performed during the first 3 days after birth, and Apgar score was estimated at 1 and 5 min after birth. Blood samples were collected from cord blood and 4 h after birth to estimate serum protein S-100, serum ionized calcium, pH, and base deficit. At 4 h after birth, there was a significant increase in serum protein S-100 and a significant decrease in serum ionized calcium in asphyxiated newborns compared with controls, and also a significant difference between asphyxiated newborns with moderate or severe HIE and asphyxiated newborns with no or mild HIE. Both markers had a high positive predictive value and a high specificity, which in case of serum protein S-100 became more higher when combined with serum ionized calcium, cord blood pH, cord blood base deficit, and Apgar score at 1 min. We concluded that serum protein S-100 and serum ionized calcium are early markers for moderate or severe HIE after asphyxia, which help us to initiate and continue or stop the neuroprotective therapy. We concluded also that these markers are of high positive predictive value and of high specificity