Lack of prognostic significance of early elevated serum uric acid levels in low birthweight infants.

This study examined the utility of serum uric acid concentrations in the first day of life to identify infants with severe brain injury (grade III or IV intraventricular hemorrhage and/or periventricular leukomalacia). The serum uric acid concentrations in infants with severe brain injury were compared to those without. Severe brain injury was assessed in 151 infants with birthweight < or = 1,251 g admitted before 24 h of life. The risk of severe brain injury was related to 5-min Apgar scores (odds ratio 0.79, CI 0.63-0.98, p < 0.05) and seizures in the first day of life (odds ratio 4.44, CI 1.004-19.66, p < 0.05), but the mean uric acid levels did not differ between those with and without severe brain injury [5.11 +/- 1.88 mg/dl (303.9 +/- 111.8 micromol/l) vs. 5.77 +/- 2.13 mg/dl (343.2 +/- 126.7 micromol/l), p = 0.200]. Uric acid levels were related to serum creatinine (p < 0.001), time of uric acid sample (p < 0.001), maternal hypertension (p < 0.001), and base deficit (p = 0.032). Of the 80 infants seen in neurodevelopmental follow-up at a median 11 months postconceptional age, uric acid concentrations did not differ between the abnormal (n = 20) and normal subjects [5.38 +/- 1.72 mg/dl (320.0 +/- 102.3 micromol/l) vs. 6.02 +/- 2.55 mg/dl (358.1 +/- 151.8 micromol/l), p = 0.197]. Uric acid may not be a useful early marker for premature infants with severe brain injury. Copyright 2003 S. Karger AG, Basel