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Urinary Uric Acid in Neonates

Pallab Basu1, Sabyasachi Som2, Harendranath Das1, Nabendu Choudhuri2.
1Department of Biochemistry, Burdwan Medical College, Burdwan - 713104, West Bengal, India,
2Department of Pediatrics, Burdwan Medical College, Burdwan - 713104, West Bengal, India.

ADDRESS FOR CORRESPONDENCE
Dr. Pallab Basu, Akriti, 13, Dr. Nilmoni Sarkar street, Kolkata - 700090, West Bengal
Email: drpallabbasudch@gmail.com
In newborn babies many different reference normal biochemical indices and parameters in blood and urine are still lacking. A product of human body which appears in blood and in urine can be estimated in both specimens. Estimating the same in urine may be non-invasive, easy, painless, and simple. There are conditions like perinatal asphyxia, hypoxic ischemic encephalopathy etc., where serum and urinary uric acid levels may increase over the normal reference range .(1) Though standard reference values are available for serum uric acid level (2 - 6.2 mg/dl) (2)in normal newborn babies in standard text reference books, no reference standard data is found regarding the urinary uric acid level in neonates.

A randomized hospital based study applying inclusion-exclusion criteria was conducted over 12 months period in the neonatology unit, on 100 term healthy newborn babies with body weight 2.5 kg or more, and Apgar score 7 or more at 1 and 5 minutes of birth. Babies with congenital malformations, suspected metabolic disease, received diuretics, having anuria and those born to mothers having hypertension, diabetes mellitus, toxemia of pregnancy, receiving general anesthesia or drugs likely to cause depression in babies, and mother with history of febrile attack within 2 weeks before delivery were excluded from the study.

Three spot urine samples were collected few hours apart within the first 24 hours after delivery and uric acid was estimated in auto-analyzer by uricase method.(3) The results: -

Samples
Mean + Standard deviation (x + S.D)
First sample
19.0 + 4.3 mg/dl
Second sample
17.9 + 2.6 mg/dl
Third sample
18.3 + 3.7 mg/dl
Final mean of all three mean values
18.4 + 0.45 mg/dl



The differences between the first, second and third means were not statistically significant (P > 0.1).

To conclude, there was hardly any variation in the uric acid levels in three different urine samples collected several hours apart. 18.4 ± 0.45 mg/dl can be considered as the reference value for urinary uric acid of a healthy baby on day 1 and can be compared with that of the patients- data. Only spot urine can help in estimating the value instead of 24 hours samples.
 
Compliance with Ethical Standards
Funding None
 
Conflict of Interest None
 
  1. Manzke H, Dorner K, Grunitz J. Urinary hypoxanthine, xanthine and uric acid excretion in newborn in newborn infants with perinatal complications. Acta Pead Scand 1977; 66: 713 - 7.  [CrossRef]
  2. Sing M. Appendices. In: Sing M, editor. Care of the Newborn. 6ed. New Delhi: Sagar Publications. 2004: p 478.
  3. Newman DJ, Price CP. Nonprotein Nitrogen Metabolites. In: Burtis CA, Ashwood ER, editors. Tietz Fundamentals of Clinical Chemistry, 5 ed. Philadelphia: Saunders, 2001: p 422.


Cite this article as:
Basu P, Som S, Das H, Choudhuri N. Urinary Uric Acid in Neonates. Pediatr Oncall J. 2009;6: 35.
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