Comparison between creatine kinase brain isoenzyme (CKBB) activity and Sarnat score for prediction of adverse outcome following perinatal asphyxia
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David G. Sweet
Abstract
Aim: To assess whether plasma creatine kinase brain isoenzyme (CKBB) levels or Sarnat scores are more accurate for prediction of poor neurological outcome in babies with suspected birth asphyxia.
Methods: In a retrospective study of 97 babies CKBB levels were compared to the presence of severe hypoxic ischaemic encephalopathy (HIE) as a predictive test for these outcomes: developmental delay, cerebral palsy, visual problems, deafness or death from perinatal asphyxia. The tests were compared using positive predictive values (PPV) and likelihood ratios (LR) with confidence intervals (CI)
Results: 3 babies had died from perinatal asphyxia and 14 survivors were found to have neurological or developmental problems. CKBB was elevated in babies with severe HIE (p=0.0004). A receiver operator characteristic (ROC) curve showed the optimal discriminating value for CKBBto be 21 IU/L but theCKBB was a poor predictive test. For prediction of adverse outcome: CKBB > 21 sensitivity 76％, specificity 40％, PPV 21％ and LR 1.3 (95％ CI 0.8–1.7). Severe HIE sensitivity 53％, specificity 95％, PPV 69％ and LR 10.6 (95％ CI 3.8–29.2).
Conclusion: CKBB is elevated following birth asphyxia but is a poor predictor of adverse neurological outcome.
Copyright (c)1999 by Walter de Gruyter GmbH & Co. KG
Articles in the same Issue
- Contents
- Author Index
- Subject Index
- Birth of St. Mary (St. Anne’s parturition) in the light of messages from medical education: Three examples from Croatian sacral heritage
- Are color and pulsed Doppler sonography safe in early pregnancy?
- European Community Multi-Center Trial “Fetal ECG Analysis During Labor”: ST plus CTG analysis
- Prenatal and perinatal risk factors for autism
- Rupture of membranes before 26 weeks of gestation: Outcome of 148 consecutive cases
- Coagulation and fibrinolysis in viable mid-trimester pregnancies of normal, intrauterine growth retardation, chromosomal anomalies and hydrops fetalis and their eventual obstetric outcome
- Determinants of energy expenditure in ventilated preterm infants
- Perinatal outcome and management of single fetal death in twin pregnancy: A case series and review
- Comparison between creatine kinase brain isoenzyme (CKBB) activity and Sarnat score for prediction of adverse outcome following perinatal asphyxia
- Neonatal outcome in small for gestational age infants: Do they really better?
- Chronic lung disease and survival in 4 tertiary neonatal units
- Follow-up studies of newborn-babies with congenital ventriculomegaly
Articles in the same Issue
- Contents
- Author Index
- Subject Index
- Birth of St. Mary (St. Anne’s parturition) in the light of messages from medical education: Three examples from Croatian sacral heritage
- Are color and pulsed Doppler sonography safe in early pregnancy?
- European Community Multi-Center Trial “Fetal ECG Analysis During Labor”: ST plus CTG analysis
- Prenatal and perinatal risk factors for autism
- Rupture of membranes before 26 weeks of gestation: Outcome of 148 consecutive cases
- Coagulation and fibrinolysis in viable mid-trimester pregnancies of normal, intrauterine growth retardation, chromosomal anomalies and hydrops fetalis and their eventual obstetric outcome
- Determinants of energy expenditure in ventilated preterm infants
- Perinatal outcome and management of single fetal death in twin pregnancy: A case series and review
- Comparison between creatine kinase brain isoenzyme (CKBB) activity and Sarnat score for prediction of adverse outcome following perinatal asphyxia
- Neonatal outcome in small for gestational age infants: Do they really better?
- Chronic lung disease and survival in 4 tertiary neonatal units
- Follow-up studies of newborn-babies with congenital ventriculomegaly
