ALPHA-FETOPROTEIN AND PROLONGED NEONATAL JAUNDICE

Abstract

Inroduction. The factors that may influence the development of prolonged neonatal jaundice in children that are breastfed, an increased levels of serum alphafetoprotein (AFP). AFP is a fetal glycoprotein binds and transport a variety of ligands such as bilirubin and fatty acids. However, the mechanism by which AFP levels are elevated in newborns with prolonged jaundice remains to be clarified. Aim of work. To determine content of serum alphafetoprotein in newborns with prolonged jaundice, who were breastfed. Material and methods. 53 children with prolonged neonatal jaundice were admitted to the hospital. The children were divided into groups depending on the duration of jaundice. The first group included 22 children with the duration of jaundice of more than 1 month, II group included 18 children with the duration of jaundice up to 1 month, III group (comparison) was 13 children with physiological jaundice of the newborn. All children were breastfed. Results. In the biochemical blood analysis there was an increase in the concentration of serum total bilirubin due to its indirect fraction of group I and II: mean levels of total bilirubin in blood serum in the children in group I were 264,9 ± 15,5 μmol/l; II group –285,2 ± 12,8 μmol/l (p >0.05), which was significantly outperforming in children of comparison group - 185,2 ± 6,3 μmol/l (p <0.05). The serum levels of AFP were increased in the groups of children involved in the study. Thus, in group I, the mean levels of AFP 811,12 ± of 28,56 ng/ml; in group II – 763,1 ± 28,4 ng/ml, which were significantly higher than the values of serum AFP levels in children of the comparison group – 452 ± 57,9 ng/ml (p<0.05). Every third child with prolonged jaundice was observed an increased content of hepatic transaminases. Thus, children with prolonged jaundice and an increased rate of hepatic transaminases: mean AlAT was in the range of 47,5 ± 6,3 U/l; AsAT 64,7 ± 13,7 Per U/l, had significantly higher levels of serum AFP - 793,5 ± 31,5 ng/ml; although in children with low transaminase levels of serum AFP was 700,9 ± 33,7 ng/ml (p<0.05). Conclusion. The findings suggest that children with the most prolonged course of jaundice, observed the maximum content of serum alpha-fetoprotein, indicating the role of damage of hepatocytes in the genesis of prolonged neonatal jaundice. In children with elevated hepatic transaminases levels of serum alpha-fetoprotein were significantly higher.