Hepatic aminotransferases of normal and IUGR fetuses in cord blood at birth

作者：Kocylowski Rafal; Dubiel Mariusz; Gudmundsson Saemundur; Fritzer Elfriede; Kiserud Torvid; von Kaisenberg Constantin^*

来源：Early Human Development, 2012, 88(7): 461-465.

DOI：10.1016/j.earlhumdev.2011.11.001

• Obstetrics
• Fetal medicine
• Perinatology
• Pediatric growth
• Development

Background: The accepted standard for assessing the wellbeing of the newborn is the Apgar score and blood gas analysis. However, the prediction of neonatal morbidity or mortality is limited. In small-for-gestation (SGA) fetuses at 18-38 weeks of gestation, pO(2) is %26lt;5th centile both in the umbilical artery and vein in 30%. In a previous study in singleton term neonates cardiac specific enzymes (B-type natriuretic peptide, BNP and cardiac troponin T, cTnT) are increased in growth-restricted fetuses compared with normals. %26lt;br%26gt;Aims: To test the hypothesis, that fetuses with intra uterine growth restriction (IUGR) have elevated AST (GOT) and ALT (GPT) aminotransferases as a result of hypoxic liver cell injury, and to establish references ranges. %26lt;br%26gt;Study design: Prospective cohort study, serum of umbilical artery (n = 156) and vein (n = 180), 599 normal singletons at 37(+0)-42(+0) weeks, neonates with IUGR (n = 41). analysis for pH, birthweight and maternal weight, spontaneous vs cesarean section, vein vs artery and for the sex. %26lt;br%26gt;Outcome measures: Aspartate aminotransferase (AST. GOT) and Alanine aminotransferase (ALT, GPT) were measured in normals and IUGR neonates. %26lt;br%26gt;Results: Neonates with IUGR (n = 41) had AST values that were not different from the reference group, but had significantly lower ALT (-1.49, 95% CI - 1.98 to - 1.00 vs 0.14, 95% CI - 0.42-0.13), (p%26lt;0.001), (Fig. 3). %26lt;br%26gt;Conclusions: In neonates with IUGR, hypoxic hepatic injury markers in cord blood were not elevated. Rather, a substantially reduced ALT suggests a down-regulated hepatic activity.

• 出版日期2012-7