Liver impairment among neonates with moderate to severe asphyxia

Background and Objectives: Perinatal asphyxia may cause severe damages in different organs such as kidneys, lungs, liver and most importantly CNS. The current study aimed to evaluate and compare the prevalence of liver impairment among asphyxiated and normal neonates. Methods: A retrospective case-control study was carried out in a referral pediatrics Hospital (Iran- from 2013 to 2015). Term and preterm asphyxiated neonates born in hospital were registered as the case group. Serial laboratory tests including CBC, Crateanin, BUN, Na+, K+, Ca+ and blood sugar were done. ALT, AST and ALP were also measured at day of third to fifth of life. Healthy neonates who admitted due to hyperbilirubinemia were also considered as the controls and their liver enzymes were checked at day of third to fifth of life. All participants' demographic data and laboratory findings were extracted from medical records. Liver impairment by assessing liver enzymes was compared between case and control groups. The level of significance was considered as p< 0.05. Results: Forty-nine asphyxiated neonates as the case and 20 icteric neonates as the control group entered the study. Of all asphyxiated neonates, 23 cases (46.9%) showed seizure, 25 (52.1%) type II and 23 (47.9%) type III Hypoxic-ischemic encephalopathy. Seven (10.1%) asphyxiated neonates died. More neonates in control group had gestational age > 37 weeks (p< .05). Mean and median serum ALT in case group was significantly higher than controls (p< .05). A significant difference was also observed between two groups with regard to mean serum ALP (p< .05). Elevated ALT, AST and ALP were more frequent in the case group in compare to the control group. Conclusion: Elevated ALT and ALP in 3-5 days of age can be utilized as possible predictors of perinatal asphyxia.