Hepatic enzyme alterations as prognostic markers in neonates with hypoxic-ischemic encephalopathy: A hospital-based prospective cohort study.
Background Perinatal asphyxia remains a significant contributor to neonatal morbidity and mortality, with hypoxic-ischemic encephalopathy (HIE) being a major sequela. Liver injury is a common systemic complication, and hepatic enzymes may serve as potential biomarkers for the severity of hepatic en...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Student's Journal of Health Research
2025-06-01
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| Series: | Student's Journal of Health Research Africa |
| Subjects: | |
| Online Access: | https://sjhresearchafrica.org/index.php/public-html/article/view/1794/1435 |
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| Summary: | Background
Perinatal asphyxia remains a significant contributor to neonatal morbidity and mortality, with hypoxic-ischemic encephalopathy (HIE) being a major sequela. Liver injury is a common systemic complication, and hepatic enzymes may serve as potential biomarkers for the severity of hepatic encephalopathy (HIE).
Objectives: To assess the pattern of hepatic enzyme alterations in neonates with HIE and explore their prognostic value in stratifying disease severity.
Methods
This prospective cohort study enrolled 100 term neonates with perinatal asphyxia. HIE staging was performed using the modified Sarnat and Sarnat criteria. Liver function tests, including serum glutamate oxaloacetate transaminase (SGOT), serum glutamate pyruvate transaminase (SGPT), and alkaline phosphatase (ALP), were measured on Days 1 and 3. Statistical analysis included ANOVA, post-hoc comparisons, and Chi-square tests to evaluate associations with clinical outcomes.
Results
Among the neonates, 33% had HIE Stage I, 39% Stage II, and 28% Stage III. Serial measurements showed significant increases in SGOT, SGPT, and ALP from Day 1 to Day 3 across all HIE stages (p<0.001). Enzyme elevations were most marked in Stage III. Cut-off values for predicting Stage III HIE were SGOT >77.4 U/L, SGPT >90.4 U/L, and ALP >257.1 U/L. Seizure activity (p<0.001) and mode of resuscitation (p<0.001) showed statistically significant associations with HIE severity, while maternal risk factors (p=0.72), mode of delivery (p=0.64), and place of delivery (p=0.59) did not.
Conclusion
Serial hepatic enzyme levels are reliable biochemical indicators for assessing the severity of HIE. Their prognostic relevance supports early stratification and targeted management in neonatal intensive care units.
Recommendations
Regular monitoring of hepatic enzymes in neonates with perinatal asphyxia can aid early detection and management of HIE severity. |
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| ISSN: | 2709-9997 |