Magnitude of Hypocalcemia in Hypoxic Ischemic Encephalopathy in Term Neonates

Authors

  • Noor Ul Haram Khattak Department of Pediatrics, Khyber Teaching Hospital-MTI Peshawar, Pakistan
  • Abdul Khaliq Department of Pediatrics, Khyber Teaching Hospital-MTI Peshawar, Pakistan
  • Noor Ul Saba Khattak DHQ Hospital Kohat, Pakistan
  • Haji Gul Bacha Khan Medical Complex Swabi, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i5.1772

Keywords:

Magnitude; Hypocalcemia; Hypoxic ischemic encephalopathy; Term neonates

Abstract

Hypoxic ischemic encephalopathy has continued to be a global problem for term neonates and the leading cause of hypocalcemia. Objective: The aim of this study was to find out the magnitude of hypocalcemia in hypoxic ischemic encephalopathy in term neonates. Method: The current study was carried out in neonatal intensive care unit Bacha Khan Medical Complex Gajju Khan Medical College Swabi from August 2023 to January 2024 after taking approval from the ethical committee of the institute.  All neonates (from birth to 3 days of age) presented to NICU with hypoxic ischemic encephalopathy were screened for hypocalcaemia.   5 ml venous blood sample was drawn from each participant for serum calcium (total ionized). Cobas Roche analyzer was used to measure total calcium, and an apparatus known as Easylyte was used to measure ionized calcium. Data was analyzed through SPSS.   Mean & SD had been derived for age. Post stratification chi square analysis was done and relationship of hypocalcaemia was evaluated with factors such as: ages, weight, sex, gestational age & mother’s educational status. P-value ≤0.05 was deemed as significant. Results: In the current study a total of 120 neonates with hypoxic ischemic encephalopathy were included out of which 80 (66.6%) were male and 40 (33.3%) were females. The mean age of the study population was 1.0-0.7 days.  Based on the medical records, the neonate's mean birth weight was 2.85 + 0.6 kg.   Serum ionized calcium levels were 4.2 + 0.8 mg/dl on average. The operational definition of hypocalcemia states that it was observed in 41 (34.1%) of participants. The prevalence of hypocalcemia varied significantly among these factors according to the neonate's age at birth, weight at birth, and mothers' educational status (p-value <0.05). Conclusion: Our study concluded that one of the major causes of hypocalcemia (34%) in term neonates is hypoxic ischemic encephalopathy.

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References

Volpe JJ. Hypoxic-ischemic encephalopathy: neuropathology and pathogenesis. Neurology of the Newborn. 2001.

Antonucci R, Porcella A, Pilloni MD. Perinatal asphyxia in the term newborn. Journal of Pediatric and Neonatal Individualized Medicine (JPNIM). 2014;3(2):e030269-e.

de Cerio FG, Lara-Celador I, Alvarez A, Hilario E. Neuroprotective therapies after perinatal hypoxic-ischemic brain injury. Brain sciences. 2013;3(1):191-214.

Shankaran S. The postnatal management of the asphyxiated term infant. Clinics in perinatology. 2002;29(4):675-92.

Shankaran S, Laptook AR, Pappas A, McDonald SA, Das A, Tyson JE, et al. Effect of depth and duration of cooling on death or disability at age 18 months among neonates with hypoxic-ischemic encephalopathy: a randomized clinical trial. Jama. 2017;318(1):57-67.

Ferriero DM. Protecting neurons. Epilepsia. 2005;46:45-51.

Bäcke P, Bruschettini M, Blomqvist YT, Sibrecht G, Olsson E. Interventions for the management of pain and sedation in newborns undergoing therapeutic hypothermia for hypoxic-ischemic encephalopathy: a systematic review. Pediatric Drugs. 2023;25(1):27-41.

Wang Z, Zhang P, Zhou W, Xia S, Zhou W, Zhou X, et al. Neonatal hypoxic-ischemic encephalopathy diagnosis and treatment: a National Survey in China. BMC pediatrics. 2021;21(1):261.

Nair J, Kumar VH. Current and emerging therapies in the management of hypoxic ischemic encephalopathy in neonates. Children. 2018;5(7):99.

Laptook A, Tyson J, Shankaran S, McDonald S, Ehrenkranz R, Fanaroff A, et al. Elevated temperature after hypoxic-ischemic encephalopathy: risk factor for adverse outcomes. Pediatrics. 2008;122(3):491-9.

Morales P, Bustamante D, Espina-Marchant P, Neira-Peña T, Gutiérrez-Hernández MA, Allende-Castro C, et al. Pathophysiology of perinatal asphyxia: can we predict and improve individual outcomes? EPMA Journal. 2011;2:211-30.

Vayalthrikkovil S, Bashir R, Espinoza M, Irvine L, Scott JN, Mohammad K. Serum calcium derangements in neonates with moderate to severe hypoxic ischemic encephalopathy and the impact of therapeutic hypothermia: a cohort study. The Journal of Maternal-Fetal & Neonatal Medicine. 2020;33(6):935-40.

Prempunpong C, Efanov I, Sant’Anna G. Serum calcium concentrations and incidence of hypocalcemia in infants with moderate or severe hypoxic-ischemic encephalopathy: Effect of therapeutic hypothermia. Early Human Development. 2015;91(9):535-40.

Nayirat M. Prevalence of Hypocalcemia in Term Neonates With Moderate and Severe Perinatal Asphyxia in Kenyatta National Hospital: University of Nairobi; 2016.

Jajoo D, Kumar A, Shankar R, Bhargava V. Effect of birth asphyxia on serum calcium levels in neonates. The Indian Journal of Pediatrics. 1995;62:455-9.

Basu P, Som S, Das H, Choudhuri N. Electrolyte status in birth asphyxia. The Indian Journal of Pediatrics. 2010;77:259-62.

AN O. Prevalence of neonatal hypocalcaemia among full-term infants with severe birth asphyxia. Pacific Journal of Medical Sciences. 2011:3-12.

Elsary AY, Elgameel AA, Mohammed WS, Zaki OM, Taha SA. Neonatal hypocalcemia and its relation to vitamin D and calcium supplementation. Saudi medical journal. 2018;39(3):247.

Jain A, Agarwal R, Sankar MJ, Deorari A, Paul VK. Hypocalcemia in the newborn. The Indian Journal of Pediatrics. 2010;77:1123-8.

Shamaoon M, Razzaq N, Ahsan M, Ahmad A, Maqbool T, Chaudhary AJ. Electrolyte imbalance in neonates with hypoxic ischemic encephalopathy: A single center study. The Professional Medical Journal. 2020;27(10):2159-64.

Acharya A, Swain B, Pradhan S, Jena PK, Mohakud NK, Swain A, et al. Clinico-biochemical correlation in birth asphyxia and its effects on outcome. Cureus. 2020;12(11).

Lowe DW, Hollis BW, Wagner CL, Bass T, Kaufman DA, Horgan MJ, et al. Vitamin D insufficiency in neonatal hypoxic–ischemic encephalopathy. Pediatric research. 2017;82(1):55-62.

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Published

2025-05-31

How to Cite

Khattak, N. U. H. ., Khaliq, A. ., Khattak, N. U. S. ., & Gul, H. . (2025). Magnitude of Hypocalcemia in Hypoxic Ischemic Encephalopathy in Term Neonates. Biological and Clinical Sciences Research Journal, 6(5), 111–114. https://doi.org/10.54112/bcsrj.v6i5.1772

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Original Research Articles