Effect of severe perinatal asphyxia on pituitary and thyroid functions in neonates

Introduction: Oxidative stress plays a significant role in pathogenesis of perinatal asphyxia. Data is scarce regarding changes in pituitary and thyroid functions and their correlation with oxidative stress parameters in perinatal asphyxia. The current study was undertaken to evaluate pituitary and thyroid functions in perinatal asphyxia,  ascertain their prognostic significance and relation with oxidative stress parameters. Material and Methods: Thirty cases and controls each  were assessed at birth for cord blood TSH, FT 4 , FT 3 , prolactin,cortisol, growth hormone, protein carbonyl and Malondialdehyde.  The cases were reassessed for these parameters at 48-72 hrs after birth. Results: The median cord blood GH and prolactin were higher in cases with normalization of latter at 48-72 hrs. FT 3 level was higher in cases at birth and FT 3 and FT 4 levels increased at 48-72 hrs after birth. At birth, serum cortisol was lower and malondialdehyde and protein carbonyls levels were higher in cases. Significant positive correlation was seen between serum levels of oxidative stress markers and FT 3 . ROC shows cord blood FT 3 level can predict HIE stage 3/death in perinatal asphyxia at optimum cut off of 2.62pmol/L. Conclusions: Perinatal asphyxia is associated with pituitary, thyroid and adrenal dysfunctions, with FT 3 having prognostic implications. Oxidative stress plays a role in pathogenesis.