urinary uric acid and creatinine ratio as a marker of perinatal asphyxia

Background: prediction of the outcome of perinatal asphyxia (pa) is important but formidable. apgar score has a limited role in predicting the outcome. urinary uric acid and creatinine ratio (ua/cr) is an early, noninvasive, and cheap biomarker of pa which may predict its morbidity. this study aimed to determine the urinary ua/cr in neonates with pa, compare it with ua/cr in non-asphyxiated neonates, and derive the optimum cut-off value of this ratio to label pa.methods: this observational cross-sectional study was carried out on 100 term neonates appropriate for gestational age (aga) with pa (cases) and 100 non-asphyxiated term aga babies (controls). urine samples were collected within 24 h of life; moreover, uric acid and creatinine levels were determined by an auto-analyzer.results: the mean urinary ua/cr ratio was significantly higher in the cases, compared to the controls (3.41±0.68 vs. 1.99±0.23) (p<0.0001). the cut-off value of this ratio to label pa was>2.5 with sensitivity, specificity, positive predictive value, and negative predictive value of 98%. urinary ua/cr ratio and cord blood ph were significantly correlated with each other (correlation coefficient r=-0.8951, p<0.001). moreover, the urinary ua/cr ratio and 5-min apgar score were also significantly correlated with each other (r=-0.8806, p<0.001).conclusion: urinary ua/cr ratio is a non-invasive, cheap, and reliable marker for pa with good predictive value in this study.