The role of proteinuria on a simple urinalysis in neonatal hypoxic–ischemic encephalopathy: association with clinical and neurodevelopmental outcomes
BackgroundEarly diagnosis and initiation of hypothermia therapy for neonatal hypoxic–ischemic encephalopathy (HIE) are critical within the first 6 h after birth. Collecting urine, especially from neonates with HIE, can be challenging and time-consuming post-birth due to the likelihood of renal injur...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-03-01
|
| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1451346/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849773718884057088 |
|---|---|
| author | Ya-Chun Hu Ya-Chun Hu Ya-Chun Hu Ji-Nan Sheu Ji-Nan Sheu Ji-Nan Sheu Inn-Chi Lee Inn-Chi Lee Inn-Chi Lee |
| author_facet | Ya-Chun Hu Ya-Chun Hu Ya-Chun Hu Ji-Nan Sheu Ji-Nan Sheu Ji-Nan Sheu Inn-Chi Lee Inn-Chi Lee Inn-Chi Lee |
| author_sort | Ya-Chun Hu |
| collection | DOAJ |
| description | BackgroundEarly diagnosis and initiation of hypothermia therapy for neonatal hypoxic–ischemic encephalopathy (HIE) are critical within the first 6 h after birth. Collecting urine, especially from neonates with HIE, can be challenging and time-consuming post-birth due to the likelihood of renal injury.PurposeWe assessed whether urine protein levels, measured via a simple urinalysis on the first day, could correlate with the outcomes of neonatal HIE.MethodsWe conducted urine analyses of patients with neonatal HIE on the first day to establish a correlation between the severity of HIE and neurodevelopmental outcomes at ≥1 year of age. Eighty-three patients were enrolled, encompassing cases of mild (n = 37), moderate (n = 30), and severe (n = 16) HIE. Three cases were excluded due to mortality caused by severe HIE with associated auria. Based on urine protein levels, patients were grouped as 0 to 30 mg/dL (group 1), 30 to 100 mg/dL (group 2), 100 to 300 mg/dL (group 3), and ≥ 300 mg (group 4).ResultsUrine protein levels were correlated with serum lactic acid levels [p = 0.006; r (81) = 0.304; n = 83], clinical staging [p = 0.001; r (81) = 0.36], and neurodevelopmental outcomes at ≥1 year of age [X2 (3, n = 83) = 11.35; p = 0.009]. The odds ratio for moderate-to-severe HIE in group 4 patients was 7.66 [p = 0.010; 95% confidence interval (CI), 1.61–36.33] compared with those in groups 1–3. Those in group 4 had a high positive predictive value (87.50%) and high specificity (94.59%).ConclusionElevated urine protein levels observed in the first urinalysis conducted on the day after birth were found to be associated with serum lactic acid levels, clinical staging, and neurodevelopmental outcomes at ≥1 year of age. |
| format | Article |
| id | doaj-art-c65c496ec6e8472cada46e68006f2bb9 |
| institution | DOAJ |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj-art-c65c496ec6e8472cada46e68006f2bb92025-08-20T03:01:58ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-03-011610.3389/fneur.2025.14513461451346The role of proteinuria on a simple urinalysis in neonatal hypoxic–ischemic encephalopathy: association with clinical and neurodevelopmental outcomesYa-Chun Hu0Ya-Chun Hu1Ya-Chun Hu2Ji-Nan Sheu3Ji-Nan Sheu4Ji-Nan Sheu5Inn-Chi Lee6Inn-Chi Lee7Inn-Chi Lee8Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, TaiwanDivision of Pediatric Neurology, Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, TaiwanInstitute of Medicine, School of Medicine, Chung Shan Medical University, Taichung, TaiwanDepartment of Pediatrics, Chung Shan Medical University Hospital, Taichung, TaiwanInstitute of Medicine, School of Medicine, Chung Shan Medical University, Taichung, TaiwanDivision of Pediatric Nephrology, Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, TaiwanDepartment of Pediatrics, Chung Shan Medical University Hospital, Taichung, TaiwanDivision of Pediatric Neurology, Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, TaiwanInstitute of Medicine, School of Medicine, Chung Shan Medical University, Taichung, TaiwanBackgroundEarly diagnosis and initiation of hypothermia therapy for neonatal hypoxic–ischemic encephalopathy (HIE) are critical within the first 6 h after birth. Collecting urine, especially from neonates with HIE, can be challenging and time-consuming post-birth due to the likelihood of renal injury.PurposeWe assessed whether urine protein levels, measured via a simple urinalysis on the first day, could correlate with the outcomes of neonatal HIE.MethodsWe conducted urine analyses of patients with neonatal HIE on the first day to establish a correlation between the severity of HIE and neurodevelopmental outcomes at ≥1 year of age. Eighty-three patients were enrolled, encompassing cases of mild (n = 37), moderate (n = 30), and severe (n = 16) HIE. Three cases were excluded due to mortality caused by severe HIE with associated auria. Based on urine protein levels, patients were grouped as 0 to 30 mg/dL (group 1), 30 to 100 mg/dL (group 2), 100 to 300 mg/dL (group 3), and ≥ 300 mg (group 4).ResultsUrine protein levels were correlated with serum lactic acid levels [p = 0.006; r (81) = 0.304; n = 83], clinical staging [p = 0.001; r (81) = 0.36], and neurodevelopmental outcomes at ≥1 year of age [X2 (3, n = 83) = 11.35; p = 0.009]. The odds ratio for moderate-to-severe HIE in group 4 patients was 7.66 [p = 0.010; 95% confidence interval (CI), 1.61–36.33] compared with those in groups 1–3. Those in group 4 had a high positive predictive value (87.50%) and high specificity (94.59%).ConclusionElevated urine protein levels observed in the first urinalysis conducted on the day after birth were found to be associated with serum lactic acid levels, clinical staging, and neurodevelopmental outcomes at ≥1 year of age.https://www.frontiersin.org/articles/10.3389/fneur.2025.1451346/fullnewbornhypoxic–ischemic encephalopathybiomarkerproteinurianeurodevelopmental outcomes |
| spellingShingle | Ya-Chun Hu Ya-Chun Hu Ya-Chun Hu Ji-Nan Sheu Ji-Nan Sheu Ji-Nan Sheu Inn-Chi Lee Inn-Chi Lee Inn-Chi Lee The role of proteinuria on a simple urinalysis in neonatal hypoxic–ischemic encephalopathy: association with clinical and neurodevelopmental outcomes Frontiers in Neurology newborn hypoxic–ischemic encephalopathy biomarker proteinuria neurodevelopmental outcomes |
| title | The role of proteinuria on a simple urinalysis in neonatal hypoxic–ischemic encephalopathy: association with clinical and neurodevelopmental outcomes |
| title_full | The role of proteinuria on a simple urinalysis in neonatal hypoxic–ischemic encephalopathy: association with clinical and neurodevelopmental outcomes |
| title_fullStr | The role of proteinuria on a simple urinalysis in neonatal hypoxic–ischemic encephalopathy: association with clinical and neurodevelopmental outcomes |
| title_full_unstemmed | The role of proteinuria on a simple urinalysis in neonatal hypoxic–ischemic encephalopathy: association with clinical and neurodevelopmental outcomes |
| title_short | The role of proteinuria on a simple urinalysis in neonatal hypoxic–ischemic encephalopathy: association with clinical and neurodevelopmental outcomes |
| title_sort | role of proteinuria on a simple urinalysis in neonatal hypoxic ischemic encephalopathy association with clinical and neurodevelopmental outcomes |
| topic | newborn hypoxic–ischemic encephalopathy biomarker proteinuria neurodevelopmental outcomes |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1451346/full |
| work_keys_str_mv | AT yachunhu theroleofproteinuriaonasimpleurinalysisinneonatalhypoxicischemicencephalopathyassociationwithclinicalandneurodevelopmentaloutcomes AT yachunhu theroleofproteinuriaonasimpleurinalysisinneonatalhypoxicischemicencephalopathyassociationwithclinicalandneurodevelopmentaloutcomes AT yachunhu theroleofproteinuriaonasimpleurinalysisinneonatalhypoxicischemicencephalopathyassociationwithclinicalandneurodevelopmentaloutcomes AT jinansheu theroleofproteinuriaonasimpleurinalysisinneonatalhypoxicischemicencephalopathyassociationwithclinicalandneurodevelopmentaloutcomes AT jinansheu theroleofproteinuriaonasimpleurinalysisinneonatalhypoxicischemicencephalopathyassociationwithclinicalandneurodevelopmentaloutcomes AT jinansheu theroleofproteinuriaonasimpleurinalysisinneonatalhypoxicischemicencephalopathyassociationwithclinicalandneurodevelopmentaloutcomes AT innchilee theroleofproteinuriaonasimpleurinalysisinneonatalhypoxicischemicencephalopathyassociationwithclinicalandneurodevelopmentaloutcomes AT innchilee theroleofproteinuriaonasimpleurinalysisinneonatalhypoxicischemicencephalopathyassociationwithclinicalandneurodevelopmentaloutcomes AT innchilee theroleofproteinuriaonasimpleurinalysisinneonatalhypoxicischemicencephalopathyassociationwithclinicalandneurodevelopmentaloutcomes AT yachunhu roleofproteinuriaonasimpleurinalysisinneonatalhypoxicischemicencephalopathyassociationwithclinicalandneurodevelopmentaloutcomes AT yachunhu roleofproteinuriaonasimpleurinalysisinneonatalhypoxicischemicencephalopathyassociationwithclinicalandneurodevelopmentaloutcomes AT yachunhu roleofproteinuriaonasimpleurinalysisinneonatalhypoxicischemicencephalopathyassociationwithclinicalandneurodevelopmentaloutcomes AT jinansheu roleofproteinuriaonasimpleurinalysisinneonatalhypoxicischemicencephalopathyassociationwithclinicalandneurodevelopmentaloutcomes AT jinansheu roleofproteinuriaonasimpleurinalysisinneonatalhypoxicischemicencephalopathyassociationwithclinicalandneurodevelopmentaloutcomes AT jinansheu roleofproteinuriaonasimpleurinalysisinneonatalhypoxicischemicencephalopathyassociationwithclinicalandneurodevelopmentaloutcomes AT innchilee roleofproteinuriaonasimpleurinalysisinneonatalhypoxicischemicencephalopathyassociationwithclinicalandneurodevelopmentaloutcomes AT innchilee roleofproteinuriaonasimpleurinalysisinneonatalhypoxicischemicencephalopathyassociationwithclinicalandneurodevelopmentaloutcomes AT innchilee roleofproteinuriaonasimpleurinalysisinneonatalhypoxicischemicencephalopathyassociationwithclinicalandneurodevelopmentaloutcomes |