Study of hepatic enzymes in term neonates with perinatal asphyxia

Abstract

Introduction: Perinatal asphyxia is among the three most common causes of neonatal deaths. Neonates with birth asphyxia suffer from hypoxic ischemic encephalopathy. They also develop multiorgan dysfunction including hepatic injury which leads to increase in liver enzymes in the blood. In this case control study, we studied the severity of liver dysfunction in term neonates with perinatal asphyxia as compared to normal neonates. Materials and Method: This case control study was conducted in the Department of Paediatrics of a tertiary care hospital in central rural India from January 2016 to June 2017. 75 term neonates were recruited in the study as cases and sex – matched 150 term neonates without birth asphyxia as controls. Basic socio- demographic factors, obstetrical history, birth weight, gestational age, apgar score of the neonates at 1 minute and 5 minutes were noted. Serum alkaline phosphatase (ALP), alanine transaminase (ALT) and aspartate transaminase (AST) were measured at 72 ± 2 hrs. Data was analyzed to understand the strength of relationship between enzyme levels and severity of asphyxia. Result: Mean Serum alanine transaminase (ALT) and aspartate transaminase (AST) in cases (90.44 U/L and 114.56 U/L respectively) were found to be significantly higher than in controls (28.34 U/L and 71.48 U/L respectively). There was no significant correlation in serum alkaline phosphatase in these groups. There was statistically significant negative correlation between Apgar scores and Serum alanine transaminase (ALT) and aspartate transaminase (AST). Conclusion: In the present study, we found a significant correlation between presence of a low Apgar score and raised serum alanine transaminase and aspartate transaminase. These biochemical parameters indicate the presence of hepatic dysfunction in asphyxiated neonates.