Role of Caspase-3 Level in Perinatal Asphyxia

Background: Perinatal asphyxia is the main cause of neurodevelopmental sequelae and perinatal death. Caspase-3 is a major enzyme associated with apoptosis and increases in hypoxic-ischemic events. There is still no reliable biomarker to predict the severity and outcome of an asphyxial event. In this regard, this study aimed to determine the caspase-3 level and its role as an outcome predictor in perinatal asphyxia. Methods: This paired-group observational analytical cross-sectional study lasted from September 2016 to February 2017. In total, 50 neonates were included in the research and Caspase-3 levels were examined at two different times. Student's t-test and logistic regression analysis were used for statistical analysis. Results: There were 23 neonates (46%) with hypoxic-ischemic encephalopathy (HIE) and an increase in Caspase-3 level by 0.3135 points from the first to the second examination (t=6.555; P<0.0001). Results of this study showed a significant correlation between the caspase-3 level and mortality in neonates with HIE during both the initial (RR=2.33; P=0.014) and subsequent examinations (RR=2.25; P=0.015). Conclusion: There is a significant increase in Caspase-3 levels in infants who suffer from perinatal asphyxia which can predict mortality in neonates with HIE.