| Description: |
This study examined the utility of serum uric acid concentrations in the first day of life to identify infants with severe brain injury (grade III or IV intraventricular hemorrhage and/or periventricular leukomalacia). The serum uric acid concentrations in infants with severe brain injury were compared to those without. Severe brain injury was assessed in 151 infants with birthweight ≤1,251 g admitted before 24 h of life. The risk of severe brain injury was related to 5-min Apgar scores (odds ratio 0.79, CI 0.63–0.98, p < 0.05) and seizures in the first day of life (odds ratio 4.44, CI 1.004–19.66, p < 0.05), but the mean uric acid levels did not differ between those with and without severe brain injury [5.11 ± 1.88 mg/dl (303.9 ± 111.8 µmol/l) vs. 5.77 ± 2.13 mg/dl (343.2 ± 126.7 µmol/l), p=0.200]. Uric acid levels were related to serum creatinine (p < 0.001), time of uric acid sample (p < 0.001), maternal hypertension (p < 0.001), and base deficit (p=0.032). Of the 80 infants seen in neurodevelopmental follow-up at a median 11 months postconceptional age, uric acid concentrations did not differ between the abnormal (n = 20) and normal subjects [5.38 ± 1.72 mg/dl (320.0 ± 102.3 µmol/l) vs. 6.02 ± 2.55 mg/dl (358.1 ± 151.8 µmol/l), p = 0.197]. Uric acid may not be a useful early marker for premature infants with severe brain injury. |