Neonatal Creatine Phosphokinase as A Marker of Foetal Hypoxia in Cases with Intrapartum Pathological Cardiotocography | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 139, Volume 99, Issue 1, April 2025, Page 2356-2362 PDF (178.09 K) | ||||
| DOI: 10.21608/ejhm.2025.433388 | ||||
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| Abstract | ||||
| Background: Perinatal asphyxia remains a significant cause of neonatal morbidity and mortality worldwide. Early identification of hypoxia and tissue injury is essential for timely intervention. Traditional markers like umbilical cord pH have limitations in predicting neonatal outcomes, prompting investigation into biochemical biomarkers such as creatine kinase (CK) for early detection. Objective: This study aimed to evaluate the utility of immediate umbilical cord blood CK levels as a biomarker for neonatal hypoxia and its correlation with clinical outcomes in full-term infants. Patients and methods: A controlled clinical trial was conducted on 40 full-term infants delivered at Ain Shams University Maternity Hospital through the period from 2016 to 2018. Participants were divided into two groups: 20 infants with normal cardiotocography (CTG) patterns (Group 1) and 20 with pathological CTG requiring urgent intervention (Group 2). Blood samples were collected within five minutes of delivery to simultaneously measure pH and CK levels using electrochemiluminescence immunoassay. Primary outcomes included Apgar scores at 1 and 5 minutes and umbilical arterial pH, while secondary outcomes assessed NICU admission, neonatal complications, and mortality. Results: Infants in the pathological CTG group exhibited significantly higher CK levels (mean >255 U/L) compared to the normal group, correlating with lower Apgar scores and acidemia (pH <7.00). Elevated CK levels were associated with increased neonatal hypoxia indicators, including neurological signs and need for intensive care. No significant differences in CK levels were observed based on mode of delivery. Immediate CK measurement demonstrated high sensitivity and specificity in detecting hypoxia-related tissue injury. Conclusion: Umbilical cord CK levels measured immediately after birth were reliable biomarkers for neonatal hypoxia and tissue injury. Incorporating CK assessment into routine neonatal evaluation can facilitate early detection and improve management of hypoxic neonates, potentially reducing adverse outcomes. | ||||
| Keywords | ||||
| Creatine phosphokinase; Hypoxia; Cardiotocography | ||||
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