HYPOCALCEMIA IN NEONATES WITH HYPOXIC ISCHEMIC ENCEPHALOPATHY: A CROSS SECTIONAL STUDY

Abstract

Objectives: To determine the frequency of hypocalcemia in neonates with hypoxic-ischemic encephalopathy (HIE) and explore some of the associated factors.
Methods and materials: A cross-sectional study conducted at Lady Reading Hospital (LRH)
Peshawar, Khyber Pakhtunkhwa, from January-June 2019. The sample size was 116 using 18%
proportion of patients with HIE in the nursery, 95% confi dence level and 07% margin of error,
under the WHO sample size calculator. We employed consecutive non-probability sampling and
included neonates who presented to the neonatal unit of LRH with more than one-minute delayed
cry, 1-minute APGAR score of 3 or less, and neurological impairment evaluated for hypocalcemia. The parents/caregivers consented, once the purpose and benefi ts of study were explained to
them. For serum calcium (total ionized), a 5ml venous blood sample was taken from all included
neonates without applying the tourniquet to avoid artefactual hemoconcentration.
Results: There were total 116 neonates with HIE. Among these 76 (65.5%) were males while the
mean age of the sample was 1.9 + 0.8 days. Hypocalcemia was recorded in more than a quarter
(33.6%) of neonates. The occurrence of hypocalcemia was signifi cantly diff erent among the categories of age of neonate at birth, weight at birth, and educational status of mothers.
Conclusion: Hypocalcemia was common in neonates who presented with HIE. However, for
more conclusive evidence the association between serum calcium and HIE needs to be studied
in details particularly case control studies for better understanding of eff ect modifi er and risk
factors associated.