الفهرس 
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Abstract
Perinatal asphyxia, also known as neonatal asphyxia or birth asphyxia, is a medical condition defined as a lack of blood flow or gas exchange to or from the fetus before, during, or even after the labor process (Sugiura-Ogasawara., et al. 2019). Birth asphyxia can cause neurologic sequelae as a result of low supply of blood flow or oxygen and as a result of this lack, there is a partial hypoxia or complete anoxia which may lead to multi-organ failure including liver, heart, muscle, and brain involvement as a major organ of concern; moreover, a lactic acidosis and anaerobic glycolysis will result (Hakobyan., et al. 2019).
This study aims to study blood levels of Lactate, Vitamin D and Nucleated Red Blood Cells as Biochemical Predictors of Hypoxic–Ischemic Encephalopathy after Perinatal Asphyxia.
This prospective cohort study was conducted on 40 neonates, 20 HIE patients group specified with AAP criteria with Apgar score ≤4, acidosis with PH <7, and Base deficit >10. They were compared to 20 appearing healthy neonates of matched sex and age as a control group.
All children were subjected to: detailed full history, clinical examinations, routine lab (CBC, ALT, AST, serum creatinine, urea levels, random blood glucose, RBS and C-reactive protein), and specific lab investigations.
The results of the current study showed:
1. Apgar score was significant lower in HIE group than normal control group.
2. Maternal risk factors occurred more frequently to a highly statistically significance in group 1 compared to group Ⅱ (100% and 20% in group 1 and Ⅱ respectively).
3. there were high statistically significantly increased rates of tachypnea, systolic blood pressure, RR, retraction, grunting, cyanosis, and need for resuscitation in HIE group than in control group. There were no statistically significant differences. Regarding HC, weight and Temperature between both groups. Also, there were statistically significant differences as regards height, diastolic blood pressure, and HR between HIE group and control group.
4. There was a highly significant difference between both groups in terms of occurrence of sepsis. It also showed a highly significant increase in HIE group than control group in terms of mortality, and need for respiratory support. There was a significant increase in the mean duration of incubation in HIE group compared to the control one.
5. We reported 5 neonates as mild HIE, 7 neonates as moderate HIE, and 8 neonates as severe HIE.
6. There were higher rate of PCO2 and lower rates of PH and HCO3 in HIE group than control group.
7. There were higher rates of CRP and RBS and lower rates of TSB in HIE group than control group.
8. NRBCs count per 100 WBC was significantly higher in HIE neonates than control group. Moreover, Serum lactate level was significantly higher in HIE group than normal control group. Also, Vitamin D level was significantly lower in HIE group compared to control group.