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Randomized Controlled Trial
. 2008 Sep;153(3):375-8.
doi: 10.1016/j.jpeds.2008.03.041. Epub 2008 May 9.

Association between urinary lactate to creatinine ratio and neurodevelopmental outcome in term infants with hypoxic-ischemic encephalopathy

William Oh  1 , Rebecca Perritt, Seetha Shankaran, Matthew Merritts, Edward F Donovan, Richard A Ehrenkranz, T Michael O'Shea, Jon E Tyson, Abbot R Laptook, Abhik Das, Rosemary D Higgins
Affiliations
Randomized Controlled Trial

Association between urinary lactate to creatinine ratio and neurodevelopmental outcome in term infants with hypoxic-ischemic encephalopathy

William Oh et al. J Pediatr. 2008 Sep.

Abstract

Objective: To assess the association between urinary lactate to creatinine ratio (ULCR) and neurodevelopmental outcome in term infants with hypoxic ischemic encephalopathy and examine the effect of hypothermia on the change in ULCR.

Study design: Spot urine samples were collected in 58 term infants (28 hypothermia, 30 control subjects) with hypoxic ischemic encephalopathy. Urinary lactate and creatinine were measured by using (1)H nuclear magnetic resonance spectroscopy and expressed as ULCR. Survivors were examined at 18 months of age.

Results: The ULCR was significantly higher in infants who died or had moderate/severe neurodevelopmental disability. Logistic regression analysis controlling for hypothermia and severity of encephalopathy confirmed the association (adjusted odds ratio, 5.52; 95% CI, 1.36, 22.42; P < .02). Considerable overlap in ULCR was observed between infants with normal/mild disability and those who died or survived with moderate/severe disability. ULCR fell significantly between 6 and 24 hours and 48 and 72 hours of age for all infants. The magnitude of decline did not differ between hypothermia and control groups.

Conclusions: High ULCR is associated with death or moderate/severe neurodevelopmental disability. Significant overlap in values between the normal/mild and moderate/severe disability groups limits predictive value of this measure. Whole-body hypothermia did not affect the decline in ULCR.

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Conflict of interest statement

Authors declare no conflict of interest.

Figures

Figure
Figure
Scattergram of urinary lactate to creatinine ratio collected between 6 to 24 hours of age versus 18-month outcomes. Data for hypothermia and control groups were combined. h and c represent each hypothermic and control infant, respectively. Dotted lines indicate median values.
See this image and copyright information in PMC

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