European Journal of Molecular & Clinical Medicine

Abstract

Background: Birth asphyxia resulting in hypoxic-ischemic encephalopathy (HIE) remains a major cause of neonatal mortality and morbidity worldwide. Different organ systems of the body are affected in birth asphyxia, liver being one of them.
Method and Material: Full term neonates with APGAR score of ≤7 at five minute of life orFailure to breath spontaneously immediately after birth orRequiring resuscitative measures to sustain life after birth; Along with Umbilical cord pH <7 or base deficit ≥16mmol/lt were included. Neonates with Major congenital malformation, chromosomal abnormalities, Birth trauma and Sepsis were excluded. APGAR was recorded at 1st, and 5th minute of life. Cord blood ABG was done to diagnose perinatal asphyxia. Neonates were grouped according to Sarnat and Sarnat stages of HIE. Serums AST, ALT, ALP of asphyxiated neonates were estimated between 48 to 72 hours of life.
Results: Total 100 neonates were enrolled in the study with mean age 38±1.27 weeks and mean birth weight 2.8±0.4 kg. The M: F ratio was 1.4:1. Among 100 asphyxiated neonates 84% had HIE of varying category and 53% had hypoxic hepatic injury. Hepatic dysfunction was found in 2 of 16(12.5%) neonates with no HIE, 8 of 19(42.1%) neonates with HIE1, 28 of 45(62.2%) neonates in HIE2 and 15 of 20 (75%) neonates in HIE3. There was statistical significance in occurrence of HHI according to stages of HIE. Positive correlation was noted between serum levels of liver enzymes and HIE staging of neonates.
Conclusion: Majority of Asphyxiated neonates developed hypoxic hepatic injury. ALT, AST and ALP has positive correlation with increasing severity of HIE staging.