Uric Acid as a Predictor of Severe Intraventricular Hemorrhage in Very Low Birth Weight Infants.

Kim,  Seon Bong; Oh,  Seong Hee; Do,  Hyun Jeong; Jang,  Hee Jin; Yoon,  Jong Hyun; Lee,  Byong Sop; Kim,  Ki Soo; Kim,  Ellen Ai Rhan

doi:2015.22.1.34

Neonatal Med > Volume 22(1); 2015 > Article

Original Article

Neonatal Medicine 2015;22(1):34-39.
DOI: https://doi.org/10.5385/nm.2015.22.1.34 Published online February 28, 2015.

Uric Acid as a Predictor of Severe Intraventricular Hemorrhage in Very Low Birth Weight Infants.

Seon Bong Kim, Seong Hee Oh, Hyun Jeong Do, Hee Jin Jang, Jong Hyun Yoon, Byong Sop Lee, Ki Soo Kim, Ellen Ai Rhan Kim

¹Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. arkim@amc.seoul.kr
²Department of Pediatric Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

PURPOSE
To determine whether serum uric acid levels in the first 7 days of life can predict development of severe intraventricular hemorrhage (IVH) among very low birth weight (VLBW) infants.
METHODS
VLBW infants admitted to the neonatal intensive care unit of Asan Medical Center between January 2009 and December 2012 were selected for chart review. Infants were divided into groups with and without severe IVH (grade> or =3). To determine whether uric acid is a predictor of severe IVH, uric acid levels on the first day (within 24 hours of birth), peak uric acid levels (during the first 7 days for infants without severe IVH, prior to IVH documentation by cranial sonogram for infants with severe IVH, and trend in uric acid levels were analyzed for both groups. Various antenatal and postnatal factors were compared between the groups, and risk factors associated with severe IVH were identified.
RESULTS
A total of 397 VLBW infants were included, with mean birth weight of 1,075+/-292 g and a mean gestational age of 29.6+/-3.3 weeks. Higher levels of uric acid on day 1, higher peak levels, and rising uric acid levels were all found to be associated with the development of severe IVH on univariate analysis. Multivariate analysis confirmed that rising uric acid levels predicted subsequent development of severe IVH. Other factors associated with development of severe IVH included higher sodium, higher potassium, higher PaCO2, higher lactic acid, and lower PaO2.
CONCLUSION
Careful attention to uric acid levels, which are easily measured, may be useful in predicting subsequent development of severe IVH among VLBW infants.

Key Words: Intraventricular hemorrhage; Very low birth weight; Uric acid