Neonatal Med.  2015 Feb;22(1):34-39. 10.5385/nm.2015.22.1.34.

Uric Acid as a Predictor of Severe Intraventricular Hemorrhage in Very Low Birth Weight Infants

• Kim SB
• Oh SH
• Do HJ
• Jang HJ
• Yoon JH
• Lee BS
• Kim KS
• Kim EA

• KMID: 2052176
• DOI: http://doi.org/10.5385/nm.2015.22.1.34

Abstract

PURPOSE
To determine whether serum uric acid levels in the first 7 days of life can predict development of severe intraventricular hemorrhage (IVH) among very low birth weight (VLBW) infants.
METHODS
VLBW infants admitted to the neonatal intensive care unit of Asan Medical Center between January 2009 and December 2012 were selected for chart review. Infants were divided into groups with and without severe IVH (grade> or =3). To determine whether uric acid is a predictor of severe IVH, uric acid levels on the first day (within 24 hours of birth), peak uric acid levels (during the first 7 days for infants without severe IVH, prior to IVH documentation by cranial sonogram for infants with severe IVH, and trend in uric acid levels were analyzed for both groups. Various antenatal and postnatal factors were compared between the groups, and risk factors associated with severe IVH were identified.
RESULTS
A total of 397 VLBW infants were included, with mean birth weight of 1,075+/-292 g and a mean gestational age of 29.6+/-3.3 weeks. Higher levels of uric acid on day 1, higher peak levels, and rising uric acid levels were all found to be associated with the development of severe IVH on univariate analysis. Multivariate analysis confirmed that rising uric acid levels predicted subsequent development of severe IVH. Other factors associated with development of severe IVH included higher sodium, higher potassium, higher PaCO2, higher lactic acid, and lower PaO2.
CONCLUSION
Careful attention to uric acid levels, which are easily measured, may be useful in predicting subsequent development of severe IVH among VLBW infants.

Keyword

Intraventricular hemorrhage; Very low birth weight; Uric acid

MeSH Terms

Birth Weight
Chungcheongnam-do
Gestational Age
Hemorrhage*
Humans
Infant*
Infant, Newborn
Infant, Very Low Birth Weight*
Intensive Care, Neonatal
Lactic Acid
Multivariate Analysis
Potassium
Risk Factors
Sodium
Uric Acid*
Lactic Acid
Potassium
Sodium
Uric Acid