Study of hepatic enzyme activity as a predictor of perinatal asphyxia and its severity and outcome

Background: In spite of major advances in the knowledge of fetal and perinatal medicine, perinatal asphyxia is one of the significant causes of mortality and long-term morbidity. Outcome of asphyxiated babies depends on the severity of hypoxia which adversely affects the liver, kidney, brain, heart, and other organs leading to leakage of intracellular enzymes. Aims and Objectives: We undertook this study to estimate hepatic enzyme activity in perinatally asphyxiated babies in relation to nonasphyxiated babies and to know whether hepatic enzyme activity correlates with the severity and outcome of asphyxia. Materials and Methods: This cohort study was conducted in the Department of Pediatrics of our hospital from June 2012 to May 2013. The study included 75 asphyxiated neonates as case and 75 healthy neonates as controls. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and lactate dehydrogenase (LDH) levels were estimated by IFCC method. Data gathered from perinatal asphyxia patients and control patients in a preformed pro forma were analyzed by appropriate statistical methods. Results: Serum AST, ALT, LDH, and ALP were found significantly higher in asphyxiated babies compared to the control group (P < 0.05). The rise of AST, ALT, and LDH also showed a significant positive correlation with the severity and outcome of asphyxia. Conclusion: Estimation of hepatic enzymes can be used as a marker to diagnose the presence of perinatal asphyxia and also to assess its severity and outcome.