Frequency of Hypocalcemia in Neonates with Hypoxic Ischemic Encephalopathy Presenting Nursery Unit of Saidu Group of Teaching Hospital

Authors

  • Irfan Ullah Department of Pediatrics, Saidu Group of Teaching Hospitals, Swat, Pakistan
  • Sardar Khan Department of Pediatrics, Saidu Group of Teaching Hospitals, Swat, Pakistan
  • Muhammed Waqas Department of Pediatrics, Saidu Group of Teaching Hospitals, Swat, Pakistan
  • Shahab Alam Department of Pediatrics, Saidu Group of Teaching Hospitals, Swat, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i5.2173

Keywords:

Hypocalcaemia, Hypoxic Ischaemic Encephalopathy, Neonate, Birth Asphyxia, Calcium

Abstract

Hypoxic-ischemic encephalopathy (HIE) is a major cause of neonatal morbidity and mortality. Metabolic disturbances, including hypocalcaemia, are frequently observed in neonates with HIE and may worsen neurological outcomes if not promptly identified and managed. Early detection of hypocalcaemia is therefore essential in neonatal intensive care settings. Objective: To determine the frequency of hypocalcaemia in neonates with hypoxic-ischemic encephalopathy presenting to the nursery unit of Saidu Group of Teaching Hospital. Methods: This cross-sectional study was conducted in the Paediatric Unit of Saidu Group of Teaching Hospital from 12-01-2025 to 12-04-2025 and included 134 neonates aged 1–25 days diagnosed with hypoxic-ischemic encephalopathy. HIE was defined based on Apgar scores below 5 at 1 and 5 minutes, need for resuscitation at birth, presence of seizures, altered level of consciousness, and neuroimaging findings consistent with encephalopathy. Hypocalcaemia was defined as ionized calcium levels <4.4 mg/dL. Data were analyzed using SPSS version 21. Associations between hypocalcaemia and demographic or clinical variables were assessed, with a p-value <0.05 considered statistically significant. Results: Among 134 neonates, 86 (64.2%) were male and 48 (35.8%) were female. The mean age was 6.76 ± 6.48 days. The mean ionized calcium level was 4.55 ± 0.48 mg/dL. Hypocalcaemia was observed in 42 neonates (31.3%). A statistically significant association was found between hypocalcaemia and younger age (1–5 days) (p = 0.001). No significant associations were observed with gender, socioeconomic status, place of residence, or birth weight categories (all p > 0.05). Conclusion: The frequency of hypocalcaemia among neonates with hypoxic-ischemic encephalopathy was 31.3%. Neonates aged 1–5 days were at significantly higher risk. Routine monitoring of serum calcium levels in the early neonatal period is recommended to detect and manage hypocalcaemia in infants with HIE.

Downloads

Download data is not yet available.

References

Törn AE, Hesselman S, Johansen K, Ågren J, Wikström AK, Jonsson M. Outcomes in children after mild neonatal hypoxic ischaemic encephalopathy: a population-based cohort study. BJOG. 2023;130(13):1602-1609. https://doi.org/10.1111/1471-0528.17533

Finder M, Boylan GB, Twomey D, Ahearne C, Murray DM, Hallberg B. Two-year neurodevelopmental outcomes after mild hypoxic ischemic encephalopathy in the era of therapeutic hypothermia. JAMA Pediatr. 2020;174(1):48-55. https://doi.org/10.1001/jamapediatrics.2019.4011

Sarnat HB, Sarnat MS. Neonatal encephalopathy following fetal distress: a clinical and electroencephalographic study. Arch Neurol. 1976;33(10):696-705. https://doi.org/10.1001/archneur.1976.00500100030012

Shamaoon M, Razzaq N, Ahsan M, Ahmad A, Maqbool T, Chaudhary AJ. Electrolyte imbalance in neonates with hypoxic ischemic encephalopathy: a single-center study. Prof Med J. 2020;27(10):2159-2164. https://doi.org/10.29309/TPMJ/2020.27.10.4128

Basu P, Som S, Das H, Choudhuri N. Electrolyte status in birth asphyxia. Indian J Pediatr. 2010;77(3):259-262. https://doi.org/10.1007/s12098-010-0034-0

Zaman R, Mollah MAH, Chowdhury MAK, Mia AH, Hoque MM, Jahan I. Serum magnesium and calcium status among term asphyxiated newborns with moderate to severe HIE. J Dhaka Med Coll. 2017;26(2):148-152.

Nasrin L, Islam MB, Mir IUMA, Hossain MD, Islam MS, Ahmed MU. Electrolyte status and plasma calcium levels of birth asphyxiated neonates. Sch J App Med Sci. 2024;12(6):755-758. https://doi.org/10.36347/sjams.2024.v12i06.008

Siddiqui MA, Khawar T, Butt T. Role of intravenous magnesium sulphate in term neonates with hypoxic ischemic encephalopathy (HIE) in a low-income country: a randomised clinical trial. J Coll Physicians Surg Pak. 2021;31(7):817-821. https://doi.org/10.29271/jcpsp.2021.07.817

Conway JM, Walsh BH, Boylan GB, Murray DM. Mild hypoxic-ischaemic encephalopathy and long-term neurodevelopmental outcome: systematic review. Early Hum Dev. 2018;120:80-87. https://doi.org/10.1016/j.earlhumdev.2018.02.007

Corte-Real Babbo C, Mellet J, Rensburg JV, et al. Neonatal encephalopathy due to suspected hypoxic ischemic encephalopathy: pathophysiology, current, and emerging treatments. World J Pediatr. 2024;20(11):1-10. https://doi.org/10.1007/s12519-024-00836-9

Mrelashvili A, Mulkerrin E, Velisek L, et al. The Sarnat score for neonatal encephalopathy: origin and clinical implications. J Pediatr Neurol. 2020;113:75-79. https://doi.org/10.1016/j.pediatrneurol.2020.08.014

Ballot DE, Ramdin TD, Bandini RM, Nakwa F, Velaphi S, Coetzee M. Therapeutic hypothermia for neonatal hypoxic-ischaemic encephalopathy in low- and middle-income countries. S Afr Med J. 2021;111(12):1168-1169. https://doi.org/10.7196/SAMJ.2021.v111i12.15894

Wu YW, Backstrand KH, Zhao S, et al. Declining diagnosis of birth asphyxia and its impact on neonatal outcome metrics. Pediatrics. 2004;114(6):1584-1590. https://doi.org/10.1542/peds.2004-1516

Mia AH, Hoque MM, Chowdhury MAKA, Khan FH, Akter KR. Outcome of different grades of perinatal asphyxia in a tertiary care hospital. DS (Child) Health J. 2010;26(2):87-89.

Mercuri E, et al. Predictive value of continuous electroencephalogram delta power in neonates with hypoxic-ischemic encephalopathy. J Child Neurol. 2020;35(4):221-227. https://doi.org/10.1177/0883073820906748

Okonkwo I, Okolo A. Postnatal magnesium sulfate in asphyxiated newborns: effect on mortality in a Nigerian cohort. Int J Pediatr Neonatal Care. 2018;4(1):1-6. https://doi.org/10.15344/2455-2364/2018/136

Downloads

Published

2025-05-31

How to Cite

Ullah, I. ., Khan, S. ., Waqas, M. ., & Alam, S. . (2025). Frequency of Hypocalcemia in Neonates with Hypoxic Ischemic Encephalopathy Presenting Nursery Unit of Saidu Group of Teaching Hospital. Biological and Clinical Sciences Research Journal, 6(5), 396–399. https://doi.org/10.54112/bcsrj.v6i5.2173

Issue

Section

Original Research Articles

Most read articles by the same author(s)