Correlation of Apgar score with serum glucose, calcium and electrolytes on the asphyxiated neonates

Ashekul Islam, Farhana Yesmin, Mohammad Sayedul Islam, Nasreen Chowdhury, Mohammad Mosleh Uddin, Mohammad Alauddin, Robiul Hasan Bhuiyan


Background: Neonatal asphyxia is characterized by discrepancy of oxygen during perinatal period that can lead to severe hypoxic ischaemic organ damages followed by a fatal outcome including neurodegenerative diseases, mental retardation, and epilepsies. According to world health organization, four million neonatal deaths occurred each year due to birth asphyxia. Therefore, our study was designed to evaluate the status of serum glucose, calcium, electrolytes, and their correlation with the fetal risk factors associated with birth asphyxia.

Methods: Neonates diagnosed with birth asphyxia were considered as “cases” while neonates birth either normal or by cesarean with having no abnormality were considered as “control”. Demographics and possible risk factors of both the mother and neonate were noted. All asphyxiated neonates and controls were chosen to examine for serum glucose, calcium and electrolytes. Automated analyzers were used to estimate serum glucose, calcium, sodium and potassium.  

Results: We found that the mean serum glucose level was significantly lower in the asphyxiated neonates compared with controls, and consequently showed very strong positive correlation with the Apgar score. Furthermore, significant reduction levels were observed in serum calcium and sodium in the asphyxiated neonates, showing a linear correlation with the Apgar score. Moreover, higher serum potassium was detected in the asphyxiated neonates than in controls, showing a negative correlation with the Apgar score.

Conclusions: We validated that the examined biochemicals of asphyxiated neonates was strongly correlated with the Apgar score. Our study reinforces for adequate clinical evaluation and biochemical monitoring for early diagnosis to prevent adverse neurodevelopmental outcome.


Apgar score, Birth asphyxia, Correlation, Electrolytes, Serum

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