Correlation between cord blood endothelin-1 and traditional indicators of perinatal asphyxia

ABSTRACT

To measure cord blood endothelin-1 concentrations in infants with perinatal asphyxia and to correlate it with two "classical" markers of hypoxia the 5-mm Apgar score and cord arterial blood pH. A prospective, case control study was conducted on 24 full-term infants with a history of perinatal events suggestive of asphyxia. 5-mm Apgar score and cord arterial blood was collected immediately after delivery and was used to measure endothelin-l concentrations and cord arterial blood gases in all studied infants. Fourteen healthy full-term newborns with no evidence of perinatal asphyxia were used as controls. The perinatal asphyxia group comprised 24 full-term newborns with a mean [ +/- SD] gestational age of 38.4 +/- 1.3 weeks and a mean [ +/- SD] birth weight of 2833 +/- 508g. There was no significant differences between the perinatal asphyxia group and controls regarding the gestational age, delivery route, or gender. The Apgar score at 5 minutes in peninatal asphyxia group was markedly reduced with a mean [ +/- SD] of 4.7 +/- 1.3. Cord blood pH was significantly lower with a mean [ +/- SD] of 7.2 + 0.08 and base excess was significantly higher with a mean [ +/- SD] of 7.6 +/- 4.5 mEq/1 in perinatal asphyxia group compared to controls. Cord blood endothelin-l concentration was significantly higher in peninatal asphyxia patients compared to controls [p <0.001]. A significant negative correlation was found between cord blood endothelin-1 concentration and pH, base excess, and 5-mm Apgar score in the peninatal asphyxia group. The cord blood endothelin-1 is markedly increased in newborns with perinatal asphyxia and shows a significant negative correlation with 5-min Apgar score, cord arterial blood pH and base excess. Thus, it can be taken as a marker for perinatal asphyxia and that it would be very interesting to evaluate its usefulness as a prognostic index