Metabolomics in Context of Alpha-Ketoglutarate and Lactate in Neonates with Birth Asphyxia

Abstract

Background: Neonatal birth/perinatal asphyxia is a critical condition that can adversely affect many different bodily tissues, particularly the brain; depending on duration and severity of asphyxia, leading to difficulties and lifelong disabilities. These can be avoided by early detection of the biochemical derangements and prompt intervention. Serum alpha-ketoglutarate (α-KG) and cord blood lactate have been found to be associated with birth asphyxia and may have potential to act as biomarkers for birth asphyxia.

Methods: Serum levels of α-KG and cord blood lactate were estimated in 34 birth asphyxiated neonates with clinical evidence of asphyxia. The levels were also analyzed in 46 apparently healthy controls, and data was compared among different groups by using appropriate statistical analysis. Serum α-KG was estimated by enzyme-linked immunosorbent assay (ELISA) and cord blood lactate by blood gas autoanalyzer (BGA) in the serum samples.

Results: Serum α-KG levels were found to be increased in birth asphyxiated neonates as compared to healthy controls (p-value = 0.06). Correlation of serum α-ketoglutarate (ng/mL) levels with outcome (discharged/expired) in birth asphyxiated neonates was not found to be statistically significant (r value = 0.156, p-value = 0.384). A statisti-cally significant correlation was not found between severity of birth asphyxia and levels of serum α-ketoglutarate (ng/mL) (r value = 0.029, p-value = 0.86). Also, correlation of cord blood lactate levels (mmol/L) with severity in birth asphyxiated neonates was not found to be statistically significant (r value = 0.326, p-value = 0.10). Correlation between cord blood lactate levels (mmol/L) and outcome in birth asphyxiated neonates (discharged/ expired) was not found to be statistically significant (r value = 0.03, p-value = 0.87), while correlation of cord pH levels and severity of birth asphyxia in cases was found to be highly statistically significant (r value = -0.60, p-value < 0.01) Conclusions: Serum α-KG and cord blood lactate bear the potential to act as biomarkers in neonates with birth asphyxia.