Cord Blood Hepatic Enzymes as Biochemical Correlates of Hypoxic-Ischaemic Encephalopathy and Immediate Postnatal Outcome in Term Asphyxiated Babies

Abstract

Background: The untoward effect of perinatal asphyxia on newborns cannot be over-emphasised. Objective: This study aimed to determine whether hepatic enzymes can serve as biochemical correlates of hypoxic-ischaemic encephalopathy (HIE) and immediate outcomes. Methods: This cross-sectional study was conducted at the neonatal intensive care unit for 15 months among 70 asphyxiated and 70 healthy neonates. The clinical staging of HIE was based on the Sarnat and Sarnat classification system. A cord blood sample was obtained for the assay of Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), and Lactate dehydrogenase (LDH). The enzymatic assay was performed using the spectrophotometric method. Results: There was a significant positive correlation between AST (r = 0.644, p <0.001), ALT (r = 0.364, p = 0.002), LDH (r = 0.377, p = 0.001), and the stages of HIE. AST correlated best with the severity of asphyxia (r = 0.644, p <0.001). Of the five mortalities in this series, the cord blood enzyme levels were significantly higher than in those that survived (p <0.05), and all the enzymes demonstrated a positive correlation with mortality, best with ALT (r = 0.354, p = 0.003). Conclusion: The worse the degree of perinatal asphyxia in the newborn, the higher the serum hepatic enzymes. Elevation of serum hepatic enzymes may also be associated with the risk of death in such babies. Efforts should be made to prevent severe perinatal asphyxia, and when it becomes inevitable, appropriate and prompt management should be instituted to limit the risk of poor outcomes.