CK-MB and LDH as predictor of HIE in term babies born with perinatal asphyxia

Background: One prevalent issue affecting newborns is perinatal asphyxia, which has a substantial impact on the morbidity and mortality of newborns. Perinatal asphyxia can affect all the organ systems with a higher predilection for the nervous system resulting in neurological dysfunction which has been termed Hypoxic Ischemic Encephalopathy (HIE). It has been discovered that LDH and CK-MB have great sensitivity and specificity and that the results of these tests can be obtained right away at the bedside. Following asphyxia, there is a significant increase in LDH and CK-MB, which indicates that these enzymes may be useful in predicting the degree of hypoxic-ischaemic insult a newborn would experience. Aims: 1: To evaluate the serum CK-MB and LDH levels among asphyxiated and non-asphyxiated term neonates; 2:  To study whether these enzymes (if raised) can be used to predict the development of Hypoxic Ischaemic Encephalopathy (HIE) and its correlation with HIE staging. Materials and Methods: Newborns with perinatal asphyxia were used as cases in this prospective case-control research, whereas healthy term neonates were used as controls. Blood for CK-MB had been drawn at 8 ± 2hrs. of birth as well as LDH at 72 ± 2 hrs of birth. Results: When comparing the levels of CK-MB as well as LDH in cases versus controls, a significant p value of 0.001 was obtained. LDH was found to have more sensitivity & specificity than CK-MB and hence was found to have more diagnostic accuracy. Babies that died due to HIE 3 had marked elevation of both biomarker levels as compared to other cases of asphyxia. Conclusion: 1. LDH at 72±2 hours of birth was found to be a better diagnostic test than CK-MB for detecting HIE in cases of perinatal asphyxia; 2. LDH and CK-MB can be utilized to correlate the degree of HIE in cases of birth asphyxia.