Abstract
Hypoxic Ischaemic Encephalopathy (HIE) is a sequelae of neonates suffering from severe
perinatal asphyxia. It may also cause impaired renal function due to acute tubular necrosis
followed by elevation of urinary concentration of certain low molecular weight proteins like
β2- microglobulin. This study was designed to evaluate the urinary β2- microglobulin level
in neonates with HIE patients those who have impaired renal function.
This prospective case control study was carried out in the Neonatal unit of the
department of Pediatrics and in the Labor ward of the department of Obstetrics and
Gynecology Bangabandhu Sheik Mujib Medical University, Dhaka during the period
of 1st July 2005 to 30th June 2006.
This study was designed to estimate urinary β2- micro globulin level in the asphyxiated
newborn as well normal newborns to see any significant changes and to find out its
relation with over all outcomes of newborns with perinatal asphyxia.
In this study, 42 term newborn babies before 24 hours of age, those who failed to take
spontaneous breathing within 5 minutes of the complete delivery were taken as cases
and 40 healthy term newborns were taken as control. Asphyxiated newborns were
divided into three groups depending on the sarnat and sarnat clinical staging of HIE.
Mean±SD value of urinary β-2- micro globulin in case group 4.1 ± 2.79 mg/l and in the
control was 1.35 ± 1.08 mg/l. It shows significant (p<0.01) rise of urinary β-2 micro
globulin levels in case group. The degree of rise of urinary β-2- micro globulin was
related with the severity of HIE but blood urea and serum creatinine levels were not
increased significantly in stage I and stage II except in stage III HIE patients.
It was concluded from this study that raised urinary β2- microglobulin level may be
related with HIE patients irrespective of clinical staging but serum creatinine and blood
urea were found to be elevated only in stage III HIE patients. But to draw a conclusive
evidence regarding relationship of urinary β2 microglobulin with advance stages of HIE
in neonates with impaired renal function require further large scale study.
Key Words: urinary β-2- microglobulin, perinatal asphyxia, Hypoxic Ischaemic Encephalopathy