Alteration of Hepatic Function: Helpful to Diagnose and Assess Severity of Perinatal Asphyxia

Abstract

Background and Objectives: Diagnosis of perinatal asphyxia is mostly established
retrospectively. But it is difficult to diagnose perinatal asphyxia retrospectively in the
absence of perinatal records. As because of hypoxaemia, different organ systems of
the body are affected in perinatal asphyxia, this study was done to assess the hepatic
function for the diagnosis of perinatal asphyxia and to find out any correlation existing
between hepatic enzyme change and the severity of perinatal asphyxia.
Methods: A total of 70 full-term asphyxiated newborns (study group) were studied
during January 2008 to December 2008 in the department of Paediatrics, Mymensingh
Medical College Hospital. After enrolment these babies were grouped according to
Sarnat and Sarnat stages of HIE as stage I, II and III. Another 50 healthy newborns
were also studied as reference group. Venous blood was analyzed between 2nd and
5th day of life to estimate serum AST, ALT and alkaline phosphatase (ALP), serum
total bilirubin (STB), serum total protein (STP), serum albumin and prothrombin time
(PT). Unpaired student’s 't' test and Spearman's rank correlation was used for data
analysis and P value of <0.05 were considered significant.
Results: The mean AST, ALT, ALP, STP, S. albumin and TSB of asphyxiated babies
were 76.3±37.4 U/L, 82.2±48.08 U/L, 369.6±123.05 U/L, 55.7±8.8 U/L, 32.6±5.5 g/L
& 5.5±2.01mg/dL respectively and those of normal babies were 23.5±8.5 U/L, 26.5±7.8
U/L, 208.2±46.9 U/L, 66.3±10.4 g/L, 40.9±6.5 g/L and 4.5±1.2 mg/dl respectively and
these differences were statistically significant (P <0.001). On the other hand no
significant changes were noted in prothrombin time. The rise of AST, ALT, ALP and
PT also showed a significant positive correlation with the severity of asphyxia and the
stages of HIE.
Conclusion: It is concluded that estimation of hepatic enzymes can be used to
diagnose perinatal asphyxia and also to assess its severity.

Key words: Alanine aminotransferase; aspartate aminotransferase; newborn; perinatal
asphyxia.

DOI: 10.3329/bjch.v34i1.5695

Bangladesh Journal of Child Health 2010; Vol.34(1): 7-10