title: Hepatic aminotransferases of normal and IUGR fetuses in cord blood at birth.
abstract: 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 <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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  Aspartate aminotransferase (AST, GOT) and Alanine aminotransferase (ALT, GPT) were measured in normals and IUGR neonates.
  
  
  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<0.001), (Fig. 3).
  
  
  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.
authors.affiliation: Dept. of Obstet. and Gynecol., Poznan University of Medical Sciences, Poland.
authors.forename: Rafal
authors.initials: R
authors.lastname: Kocylowski
authors.forename: Mariusz
authors.initials: M
authors.lastname: Dubiel
authors.forename: Saemundur
authors.initials: S
authors.lastname: Gudmundsson
authors.forename: Elfriede
authors.initials: E
authors.lastname: Fritzer
authors.forename: Torvid
authors.initials: T
authors.lastname: Kiserud
authors.forename: Constantin
authors.initials: C
authors.lastname: von Kaisenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003940:Diagnostic Techniques, Endocrine / Q000592:standards; D005260:Female; D005312:Fetal Blood / Q000201:enzymology* / Q000378:metabolism; D005317:Fetal Growth Retardation / Q000097:blood* / Q000201:enzymology; D005865:Gestational Age; D006262:Health; D006801:Humans; D007231:Infant, Newborn; D008099:Liver / Q000201:enzymology; D008297:Male; D036801:Parturition / Q000097:blood* / Q000378:metabolism; D011247:Pregnancy; D012016:Reference Values; D000637:Transaminases / Q000097:blood* / Q000378:metabolism; D055815:Young Adult
chemical_list: D000637:Transaminases