Hypoxic-ischaemic injury in the developing brain is one of the major c
auses of mortality and morbidity during birth asphyxia. We estimated l
ipid peroxidation (LPO) and two key antioxidants viz. superoxide dismu
tase (SOD) and glutathione peroxidase (GPX) in 34 neonates suffering f
rom birth asphyxia, and in 25 age-matched controls, to investigate the
possible role of free radicals in cerebrospinal fluid (CSF) in birth
asphyxia. Total calcium and creatine phosphokinase (CPK) were also est
imated to determine the extent of brain damage. We categorized the pat
ients into mortality, morbidity and recovered groups according to clin
ical, biochemical, radiological investigations and death reports. LPO
levels were significantly raised in each of these groups. CPK activity
was markedly elevated in the mortality group as compared to the contr
ol and morbidity groups. Total calcium was raised in the mortality gro
up as compared to controls and recovered group only. SOD activity was
highly elevated in both mortality and morbidity groups, whereas GPX ac
tivity was significantly lower in the morbidity and recovered groups a
s compared to the controls. The increased level of LPO suggests that t
he higher production of free radicals may cause cellular damage in the
brain, which was evident from the elevated activity of CPK and level
of total calcium. The raised SOD activity also suggests higher product
ion of superoxide anions, whereas the lower GPX activity indicates the
accumulation of free radicals, resulting in higher lipid peroxidation
in the CSF. (C) 1998 Chapman & Hall Ltd.