ELECTROLYTES DERANGEMENTS IN FIRST WEEK OF LIFE IN NEONATES ADMITTED WITH BIRTH ASPHYXIA

Abstract

Background: Birth asphyxia is a major cause of neonatal morbidity and mortality and is frequently associated with electrolyte disturbances resulting from hypoxic injury and multiorgan dysfunction.

Objective: To determine the frequency of electrolyte derangements during the first week of life in neonates admitted with birth asphyxia and to evaluate their association with clinical outcomes.

Methodology: This descriptive cross-sectional study was conducted in the Department of Pediatrics, Lady Reading Hospital, Peshawar, from March 2025 to August 2025. A total of 175 full-term neonates with birth asphyxia were enrolled using consecutive non-probability sampling. Demographic, clinical, and laboratory data were collected during the first week of life. Serum sodium, potassium, calcium, and magnesium levels were measured using standard laboratory techniques. Data were analyzed using IBM SPSS version 26.

Results: Among the 175 neonates, 110 (62.9%) were male and 65 (37.1%) were female. Hyponatremia was observed in 146 (83.4%) neonates, hypokalemia in 119 (68.0%), hypocalcemia in 169 (96.6%), and abnormal magnesium levels in 29 (16.6%). Calcium status showed a significant association with survival status (p=0.002) and clinical course (p=0.014), while magnesium status was significantly associated with clinical course (p=0.010). No significant associations were observed between sodium or potassium levels and survival or clinical course (p>0.05).

Conclusion: Electrolyte derangements were highly prevalent during the first week of life in neonates with birth asphyxia. Hypocalcemia, hyponatremia, and hypokalemia were the most common abnormalities.