BIRTH ASPHYXIA;

SHORT-TERM OUTCOME OF NEONATES TREATED WITH ALLOPURINOL

Abstract

Introduction: Out of 130 million births, about four million infants die in the first four
weeks of their life. Birth asphyxia is a major cause of neonatal deaths in developing countries.
Birth asphyxia is estimated to account for approximately 25% of neonatal mortality worldwide.
Allopurinol is a cheap and freely available medicine whereas other management options are
not widely used. Objectives: To analyze the short-term outcome between allopurinol-treated
and non-allopurinol-treated asphyxiated neonates. Study Design: A randomized controlled
study. Setting: Pediatric unit 2, Bahawal Victoria Hospital, Bahawalpur. Duration of Study: This
study was conducted from March 2015 to September 2015. Materials and Methods: A total
of 62 (31 in allopurinol and 31 in non allopurinon treated group) infants having admitted within
6 hours after birth with gestational age > 36 weeks. All were suffering from stage-2 hypoxic
ischemic encephalopathy, lethargy, hypotonia, flexion posture. All were having hyperactive
tendon reflexes and poor moro reflex. All the admitted neonates were managed and followed
up to to 7 days of admission to note the need of anti-convulsants, conscious level and length
of admission in intensive care unit (< 7 days or > 7 days). Neonates who died during the stay
were noted and compared between both the groups. Results: Out of 62 infants, there were 34
(54.8%) males and 28 (45.2%) females. Mean gestational age was 37.90 weeks while mean
weight of newborn infants was 2.75 kg. Overall Mortality was noted in 6 (9.68%) infants. When
both groups were compared, no statistically significant difference was found between the two
groups in terms of sex, gestational age, birth weight or mortality (p value > 0.05). Conclusion:
Short-term outcome in terms of mortality between allopurinol-treated and conventional treatment
asphyxiated neonates was found to be 6.5 vs 12.9%.