Umbilical cord blood NGAL concentration as an early marker of perinatal asphyxia in neonates

Abstract

Introduction: Recent reports have revealed increased concentration of neutrophil gelatinase-associated lipocalin (NGAL) in cardiovascular diseases and after episodes of hypoxia. We hypothesized that elevated plasma NGAL levels could be a result of vascular endothelial injury due to perinatal asphyxia. Materials and methods: Ninety-three newborns with a gestational age ≥37 weeks, of which 32 newborns were asphyxiated (study group), and 61 were healthy children (control group), were enrolled in the study. Serum NGAL, lactate and creatinine concentrations, acid-base balance, neutrophil and white blood cell count were measured in the umbilical cord blood. Results: Asphyxiated newborns had a significantly lower pH value (7.0 vs. 7.3; p<0.001), lower HCO3 (15.8mmol/L vs. 23.2mmol/L; p<0.001) and higher lactate concentrations (7.5mmol/L vs. 2.3mmol/L; p<0.001), as compared to controls. Neutrophil count (10.3x109/L vs. 6.5x109/L; p=0.02) and NGAL concentration (122.5ng/mL vs. 24.3ng/mL p<0.001) were elevated in asphyxiated newborns as compared to healthy children. Conclusions: The measurement of NGAL in the umbilical blood can be a valuable biomarker of perinatal asphyxia in neonates. Key words: newborn / asphyxia / NGAL /