Investigation of Urinary Beta-2 Microglobulin Level in Neonates with Asphyxia Admitted in Alzahra Hospitals in Isfahan, 1396-1397

Document Type : Original Article


1 Department of Pediatrics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 2. Department of Pediatrics, Division of Neonatology, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

3 School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran


Background: Despite advances in perinatal care, perinatal asphyxia (PA) remains one of the most important causes of mortality and morbidity at birth. Asphyxia is associated with the dysfunction of different organs of the body. Therefore, this study aimed to investigate the urinary biomarker of beta-2 microglobulin in neonates with asphyxia.
Methods: This case-control study was performed on neonates admitted to the Neonatal Intensive Care Unit of AL Zahra and Shahid Beheshti hospitals affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, during 2017-18. On the second day of birth, beta-2 microglobulin was measured in urine samples using the enzyme-linked immunosorbent assay technique.
Results: The mean level of beta-2 microglobulin in the group with asphyxia (9.91±6.16) was significantly higher than that in the control group (3.83±4.03) (P=0.001). Moreover, analysis of beta-2 microglobulin level in the group with asphyxia showed that the mean serum level of neonates with acute renal failure (13.14±6.27) was significantly higher than that in newborns without acute renal failure (6.68±4.24) (P=0.02).
Conclusion: The results of our study suggest that the beta-2 microglobulin level can be evaluated as a marker of neonatal asphyxia. Furthermore, its level was significantly associated with acute kidney injury. It is suggested that further studies be conducted with a larger sample size.


  1. Popescu MR, Panaitescu AM, Pavel B, Zagrean L, Peltecu G, Zagrean AM. Getting an early start in understanding perinatal asphyxia impact on the cardiovascular system. Front Pediatr. 2020; 8:68.
  2. Desalew A, Semahgn A, Tesfaye G. Determinants of birth asphyxia among newborns in Ethiopia: A systematic review and meta-analysis. Int J Health Sci. 2020; 14(1):35-47.
  3. Brucknerová I, Ujházy E. Asphyxia in newborn-risk, prevention and identification of a hypoxic event. Neuro Endocrinol Lett. 2014; 35(Suppl 2):201-10.
  4. Moshiro R, Mdoe P, Perlman JM. A global view of neonatal asphyxia and resuscitation. Front Pediatr. 2019; 7:489.
  5. Collins KA, Popek E. Birth injury: birth asphyxia and birth trauma. Acad Forensic Pathol. 2018; 8(4):788-864.
  6. Nonato M, Gheler L, Balestrieri JV, Audi M, Prandini M. Selective head cooling and whole body cooling as neuroprotective agents in severe perinatal asphyxia. Rev Assoc Med Bras. 2019; 65(8):1116-21.
  7. Edwards A, Azzopardi D. Therapeutic hypothermia following perinatal asphyxia. Arch Dis Child Fetal Neonatal Ed. 2006; 91(2): F127-31.
  8. Argyropoulos CP, Chen SS, Ng YH, Roumelioti ME, Shaffi K, Singh PP, et al. Rediscovering beta-2 microglobulin as a biomarker across the spectrum of kidney diseases. Front Med. 2017; 4:73.
  9. Roumelioti ME, Nolin T, Unruh ML, Argyropoulos C. Revisiting the middle molecule hypothesis of uremic toxicity: a systematic review of beta 2 microglobulin population kinetics and large scale modeling of hemodialysis trials in silico. PLoS One. 2016; 11(4): e0153157.

10. Li L, Dong M, Wang XG. The implication and significance of beta 2 microglobulin: a conservative multifunctional regulator. Chin Med J. 2016; 129(4):448-55.

11. Yoo C, Yoon DH, Suh C. Serum beta-2 microglobulin in malignant lymphomas: an old but powerful prognostic factor. Blood Res. 2014; 49(3):148-53.

12. Kazemi RF, Amjadi M, Estakhri R, Amiri F. Study on urinary beta 2 macroglobulin as renal injury index after percutaneus nephrolithotripsy (PCNL). Med J Tabriz Univ Med Sci. 2008; 30(2):105-9.

13. Miksch RM, Armbrust S, Pahnke J, Fusch C. Outcome of very low birthweight infants after introducing a new standard regime with the early use of nasal CPAP. Eur J Pediatr. 2008; 167(8):909-16.

14. Bhat MA, Shah ZA, Makhdoomi MS, Mufti MH. Theophylline for renal function in term neonates with perinatal asphyxia: a randomized, placebo-controlled trial. J Pediatr. 2006; 149(2):180-4