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Background: A variety of parameters are used to identify perinatal asphyxia but they should be easily obtainable, fast and cost-effective.  Objectives: To assess the levels of serum lactate dehydrogenase (LDH), aspartate transaminase (AST) and alanine transaminase (ALT) among asphyxiated term neonates at birth (in cord blood), 0-4 hours and 18 to 24 hours after birth, to compare their levels in 3 grades of asphyxia, to correlate the values with the severity of asphyxia and to ascertain the best time interval for their estimation. Method: A hospital-based longitudinal study was done on 30 full term asphyxiated neonates. Plasma LDH, AST and ALT were tested in cord blood at birth and the neonates’ venous blood within 4 hours and between 18-24 hours. Babies were monitored clinically for evidence of hypoxic ischaemic encephalopathy (HIE) with laboratory parameters. Neonates were followed up till discharge.  Results: Serum LDH value showed a rising trend at all time points in which maximum values were observed between 18 and 24 hours of life (mean value 2153.10 ± 1992.15 U/L). On correlation of LDH, AST and ALT between the stages of HIE at different time points, strong correlation coefficients were observed between serum LDH done within 4 hours of birth and serum LDH done between 18 to 24 hours with higher stages of HIE. Conclusions: The best time period for predicting severity of asphyxia in terms of serum LDH and AST was between 18 to 24 hours whereas a high cord LDH value would suggest increased severity of asphyxia. ALT levels did not show any significance in any point of time within 24 hours. Sri Lanka Journal of Child Health, 2020; 49(2): 162-169

sri lanka journal of child health

Estimation of biomarkers in asphyxiated full term neonates with special reference to serum lactate dehydrogenase, aspartate transaminase and alanine transaminase