Liver functional status in newborns with cerebral ischemia born to mothers with exacerbation of chronic cytomegalovirus infection during the second trimester of pregnancy

Introduction. The exacerbation of chronic cytomegalovirus (CMV) infection in women during gestation often leads to altered liver function in their offspring. This may initiate activation of enzymes – markers of cytolysis, cholestasis and glycolysis – which affect the reflex sphere, excitation and inhibition processes in the brain. Considering the important role of liver enzymes in the regulatory mechanisms of the central nervous system, the relationship between biochemical parameters of the liver in cerebral ischemia of varying severity in offspring of mothers who suffered an exacerbation of chronic CMV infection during gestation has not been studied to date.
Aim. To assess the functional state of the liver in cerebral ischemia of varying severity in newborns from mothers with exacerbation of chronic CMV infection in the second trimester of pregnancy.
Materials and methods. The study involved assessing the activity of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transferase, and lactate dehydrogenase in umbilical cord serum from 42 newborns with an uncomplicated antenatal history (control group) and 68 newborns with cerebral ischemia that developed against the background of exacerbation of chronic CMV infection in their mothers in the second trimester of gestation (main group). Depending on the severity of perinatal brain injury, two subgroups were identified: the first – 36 newborns with grade I cerebral ischemia; the second – 32 newborns with grade II cerebral ischemia. Depending on the severity of perinatal brain damage, two subgroups were identified: the first – 36 newborns with cerebral ischemia of the first degree; the second – 32 newborns with cerebral ischemia of the second degree.
Results. In the first subgroup of the main group, compared with the control group, lower Apgar scores at 1 minute (p <0.001) and 5 minutes (p <0.001), as well as lower birth weight (p <0.01), were recorded. At the same time, no differences in the activity of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and gamma-glutamyl transferase were detected in the blood serum from the umbilical vein against the background of an increase in lactate dehydrogenase levels. Newborns in the second subgroup, compared with both the control group and the first subgroup, showed a decrease in Apgar scores at 1 minute (p <0.001) and 5 minutes (p <0.001), as well as birth weight (p <0.01 and p <0.001, respectively). Biochemically, newborns in the second subgroup, compared with the first subgroup, showed higher levels of aspartate aminotransferase (p <0.05), alkaline phosphatase (p <0.05), gamma-glutamyl transferase (p <0.01), and lactate dehydrogenase (p <0.05).
Conclusion. Grade II cerebral ischemia in newborns of mothers with exacerbation of chronic CMV infection during the second trimester of pregnancy, compared with grade I cerebral ischemia in newborns under similar antenatal ontogenetic conditions, is characterized by more pronounced cytolysis, cholestasis, and glycolysis activation. This reflects the negative impact of intrauterine hypoxia associated with more severe cerebral pathology in newborns from mothers with exacerbation of chronic CMV infection during the second trimester of gestation.

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