DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20204411

A study in early neonatal period for the outcome based on the hepatic involvement following severe birth asphyxia in full term neonates

Sengodi Elumalai, Rajasekaran Kathavarayan, Venkatesh Govindasamy, Sophiya Preethy S.

Abstract


Background: The current study is focused on assessing the liver involvement of severely birth asphyxiated newborns, by measuring liver enzymes like Serum glutamic oxaloacetic transaminase (SGOT) and Serum glutamic pyruvic transaminase (SGPT) to predict the outcome of those babies.

Methods: Total 111 severely birth asphyxiated newborns were assessed in a hospital based prospective analytical study. Liver enzymes were measured for all babies included in the study. Study subject details were obtained through a pre-structured questionnaire and also morbidity and mortality were noted. Analysis of the research data was done through appropriate statistical methods using SPSS version 20.

Results: It was observed that incidence of hypoxic ischemic hepatitis, among entire study population was 34.2% (38 cases) based on SGPT (>100 U/l) values. Current study findings indicated that incidence of hypoxic ischemic hepatitis had a positive correlation with hypoxic ischemic encephalopathy (HIE) staging. Mean SGOT, SGPT values were observed to increase as the HIE staging progressed. Based on Spearman’s correlation coefficient evaluation, it was determined that the elevated SGOT and SGPT values had moderate positive correlation with HIE, seizure, ventilator support and death in the study population. It was found from the present study findings that statistically significant mortality (77.4%) was observed among the HIE stage III babies, with elevated SGPT values.

Conclusions: Current study findings revealed that elevated SGOT and SGPT values (more than twice the normal) has high sensitivity to predict the outcome in severely birth asphyxiated newborns. The stated parameters can prove to be effective in counselling parents regarding morbidity and mortality of neonates due to birth asphyxia.


Keywords


Birth asphyxia, SGOT, SGPT, HIE, Neonates, Mortality, Morbidity

Full Text:

PDF

References


Ibrahim NA, Muhye A, Abdulie S. Prevalence of birth asphyxia and associated factors among neonates delivered in Dilchora referral hospital, in Dire Dawa, Eastern Ethiopia. Clin Mother Child Health. 2017;14:4.

Odd D, Heep A, Luyt K, Draycott T. Hypoxic-ischemic brain injury: Planned delivery before intrapartum events. J Neonatal Perinatal Med. 2017;10(4):347-53.

Yadav N, Damke S. Study of risk factors in children with birth asphyxia. Int J Contemp Pediatr. 2017;4(2):518-26.

Roberto A, Annalisa P, Maria DP. Perinatal asphyxia in the term newborn. J Pediatr Neonatal Individualized Med. 2014;3(2):e030269.

Wayessa JZ, Belachew T, Joseph J. Birth asphyxia and associated factors among newborns delivered in Jimma zone public hospitals, Southwest Ethiopia: a cross-sectional study. J Midwifery Reprod Health. 2018;6(2):1289-95.

Eunson P. The long-term health, social, and financial burden of hypoxic–ischemic encephalopathy. Dev Med Child Neurol. 2015;57(3):48-50.

Zanelli SA. Sarnat clinical staging of HIE. Available at: https://www.medscape.com/answers/973501-106482/what-are-the-sarnat-clinical-stages-of-hypoxic-ischemic-encephalopathy-hie. Accessed on 23 September 2020.

Giri S, Sau R, Das S, Das R, Sur P, Mondal A. Correlation of transcranial ultrasound and magnetic resonance imaging in evaluation of imaging patterns of clinically diagnosed hypoxic ischaemic encephalopathy in neonates. JEBMH. 2020;7:938-42.

Maternal and child epidemiology estimation group (MCEE). Estimates for child causes of death. Available at: https://www.who.int/maternal_child_adolescent/data/causes-death-children/en. Accessed on 23 September 2020.

Sankar MJ, Natarajan CK, Das RR, Agarwal R, Chandrasekaran A, Paul VK. When do newborns die? A systematic review of timing of overall and cause-specific neonatal deaths in developing countries. J Perinatol. 2016;36:S1-11.

Halloran R, McClure E, Chakraborty H, Chomba E, Wright LL, Carlo WA. Birth asphyxia survivors in a developing country. J Perinatol. 2009;29:243-9.

Simon LV, Hashmi MF, Bragg BN. Apgar score. 2020. Available at: https://www.ncbi.nlm.nih.gov/books/ NBK430782. Accessed on 23 September 2020.

Imai K, Vries LS, Alderliesten T, Wagenaar N, Lequin MH, Benders MJNL et al. MRI Changes in the thalamus and basal ganglia of full-term neonates with perinatal asphyxia. Neonatology. 2018;114(3):253-60.

Kapaya H, Williams R, Elton G, Anumba D. Can obstetric risk factors predict fetal acidaemia at birth? a retrospective case-control study. J Pregnancy. 2018;2018:2195965.

Ahearne CE, Boylan GB, Murray DM. Short- and long-term prognosis in perinatal asphyxia: an update. World J ClinPediatr. 2016;5(1):67-74.

Riley C, Spies LA, Prater L, Garner SL. Improving neonatal outcomes through global professional development. Adv Neonatal Care. 2019;19(1):56-64.

Kebaya LMN, Kiruja J, Maina M, Kimani S, Kerubo C, McArthur A et al. Basic newborn resuscitation guidelines for healthcare providers in Maragua District Hospital: a best practice implementation project. JBI Database System Rev Implement Rep. 2018;16(7):1564-81.

Hakobyan M, Dijkman KP, Laroche S, Naulaers G, Rijken M, Steiner K et al. Outcome of infants with therapeutic hypothermia after perinatal asphyxia and early-onset sepsis. Neonatology. 2019;115(2):127-33.

Saili A, Sarna MS, Gathwala G, Kumari S, Dutta AK. Liver dysfunction in severe birth asphyxia. Indian Pediatr. 1990;27(12):1291-4.

Islam T, Hoque SA, Mamatin. Alteration of hepatic function: Helpful to diagnose and assess severity of perinatal asphyxia. Bangladesh J child Health. 2010;34(1):7-10.

Tarcan A, Tinker F, Hakan G, Berkan G. Hepatic involvement in Perinatal Asphyxia; Baskent University. J maternal fetal neonatal med. 2007;20(5):407-10.

Hankins GD, Koen S, Gei AF, Lopez SM, Hook JWV, Anderson GD. Neonatal organ system injury in acute birth asphyxia sufficient to result in neonatal enchepalopathy. Obstet Gynecol. 2002;99(5 pt 1):688-91.

Ruiz E, Aloy F, Roiger S. Blood ammonia and trans aminases in full term infants suffering from perinatal asphyxia. Revista de Neuralgic. 2003;36(9):801-5.

Goldberg RN, Cabal LA, Sinatra FR, Plajstek CE, Hodgman JE. Hyperammonia associated with Perinatal asphyxia. Pediatrics. 1979;64:336-41.

Velaphi S, Pattinson R. Avoidable factors and causes of neonatal deaths from perinatal asphyxia-hypoxia in South Africa: national perinatal survey. Ann Trop Paediatr. 2017;27(2):99-106.