Study of dynamics of lactate dehydrogenase and hepatic enzymes activity following perinatal asphyxia in full term neonates
Abstract
Background and Objectives: Perinatal asphyxia contributes to 1.2 million neonatal deaths each year and is also associated with severe neurodevelopmental disabilities. The aim was to study the dynamics of lactate dehydrogenase, Aspartate Transaminase and Alanine Transaminase following perinatal asphyxia and correlation between the mean levels in different stages of Hypoxic Ischaemic Encephalopathy (HIE) and associated mortality.
Methodology: This is a prospective case control study of 210 term neonates, of which 158 neonates with perinatal asphyxia (who required resuscitation in the form of PPV) and 52 in the control group (normal neonates who were delivered in the hospital with no morbidities) were included. After taking the informed written consent from the parents, the relevant information from the history and physical examination were recorded in a predesigned proforma. Venous blood sample was collected at less than 12 hours and at 72 hours after the birth for estimation of LDH, AST and ALT and analysed using ANOVA, Fischer Exact test. Babies were followed up till completed 2 months of age.
Results: Incidence of hypoxic hepatitis in the present study is 62.65% with a significantly high mortality in this group. A significant difference (P <0.001) was noted between the mean enzyme values of LDH, AST and ALT in all the three stages of HIE and also in levels in between non survivors and survivors. ALT has high specificity and LDH with the highest sensitivity.
Conclusion: There seems to be a correlation between serum levels of hepatic enzymes (LDH, ALT and AST) and the extent of CNS injury in Hypoxic Ischaemic Encephalopathy.
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