الفهرس 
PERINATAL ASPHYXIAOnly 14 pages are availabe for public view
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Abstract
A
sphyxia can occur before, during, or after birth; and there is a relationship between obstetric events and neonatal outcomes, predominantly HIE in term infants. HIE in newborns can cause significant long-term neurological disability. The insult is a complex injury characterised by energy failure and disruption of cellular homeostasis, leading to mitochondrial damage. The importance of individual metabolic pathways, and their interaction in the disease process is not fully understood.
The aim of this study was to identify and quantify the metabolomic profile; namely amino acids and acylcarnitines, of umbilical cord blood samples in a carefully defined group of full term infants with perinatal asphyxia using Tandem Mass Spectrometry at genetic unit (Pediatrics hospital – Ain Shams University).
This prospective case control study was carried out on 65 neonates; 45 born with risk to asphyxia; 24 from Yemen & 21 from Egypt, and 20 born without any risk to asphyxia: 9 from Yemen & 11 from Egypt. The injury severity was defined using the modified Sarnat score. Using these classification systems, our population was divided into those with confirmed HIE (n = 16), asphyxiated infants without encephalopathy (n = 29) and matched controls (n = 20).
All infants included were subjected to detailed medical history, clinical examinations, and all had umbilical cord blood drawn for laboratory investigation “extended metabolic screening” by tandem mass spectrometry using amino acids and acyl carnitine by LC-MS.
Targeted metabolomic analysis showed alteration between study groups in 19 metabolites from 2 distinct classes (Amino Acids, Acylcarnitines). Alanine, Cit: Phe, Citruilline, Histidine, Leu-lle, Methionine, Phenylalanine, Valine, Ornithine, C0-Carinitine, C10-Carnitine, C16-Carnitine, C2-Carntine, C3, C3:C2, C4-Carnitine, C5-Carnitine, C6-Carnitine and C4-OH (C3-DC).
By fold change, t-test and PLS-DA 17 metabolites were significantly altered in the study groups (C5:1, C3:C2, C12-Carnitine, C6-Carnitine, C10-Carnitine, C4-OH (C3-DC), C10-1, C18:1, Cit: Phe, C12-carnitine, C3-carnitine, C14-carnitine, Methionine, Ornithine, Histidine, C14:1 and Arginine).
The results showed no significant difference in maternal age and gestational age sex and race between cases and controls. Head circumference mildly higher among controls compared to cases. Length and body weight were significantly lowered among cases compared to controls. There was a need for resuscitation more in HIE than asphyxia. Apgar score was lower in HIE than asphyxia and acidity of cord blood was more in HIE than asphyxia.
Different components obtained through certain meatbo-analyst software program. The percent of variability of data represented by each component can differentiate between cases and controls and the best component obtained is component number (1): (Ornithine, C6-Carnitine, C12-Carnitine, Histidine, C14:1, C10-1, C4-OH(C3-DC), C10-Carnitine, C3:C2, Arginine, C3-Carnitine, C14-Carnitine, C8:1, C18:1).
After comparing the metabolic profile arrangement of the current study with metabolic profile recorded at metabolite set library, there were some diseases that had the same arrangement of that metabolic profile such as Glycerophospholipid metabolism, Arginine and proline metabolism
Metabolite Set Enrichment Analysis identified mitochondria and liver as biologically meaningful patterns that are significantly enriched in quantitative metabolomic data.