fa پژوهشي اصیل Original Research <strong>Background and Objectives: </strong>Perinatal asphyxia may cause severe damages in different organs such as kidneys,&nbsp;lungs, liver and most importantly CNS. The current study aimed to evaluate and compare the prevalence of&nbsp;liver impairment among asphyxiated and normal neonates.<br> <strong>Methods: </strong>A retrospective case-control study was carried out in a referral pediatrics Hospital (Iran- from 2013&nbsp;to 2015). Term and preterm asphyxiated neonates born in hospital were registered as the case group. Serial laboratory&nbsp;tests including CBC, Crateanin, BUN, Na+, K+, Ca+ and blood sugar were done. ALT, AST and ALP were&nbsp;also measured at day of third to fifth of life. Healthy neonates who admitted due to hyperbilirubinemia were also<br> considered as the controls and their liver enzymes were checked at day of third to fifth of life. All participants&#39;&nbsp;demographic data and laboratory findings were extracted from medical records. Liver impairment by assessing&nbsp;liver enzymes was compared between case and control groups. The level of significance was considered as p<&nbsp;0.05.<br> <strong>Results: </strong>Forty-nine asphyxiated neonates as the case and 20 icteric neonates as the control group entered the&nbsp;study. Of all asphyxiated neonates, 23 cases (46.9%) showed seizure, 25 (52.1%) type II and 23 (47.9%) type III&nbsp;Hypoxic-ischemic encephalopathy. Seven (10.1%) asphyxiated neonates died. More neonates in control group&nbsp;had gestational age > 37 weeks (p< .05). Mean and median serum ALT in case group was significantly higher<br> than controls (p< .05). A significant difference was also observed between two groups with regard to mean serum&nbsp;ALP (p< .05). Elevated ALT, AST and ALP were more frequent in the case group in compare to the control group.<br> <strong>Conclusion:</strong> Elevated ALT and ALP in 3-5 days of age can be utilized as possible predictors of perinatal&nbsp;asphyxia. Birth asphyxia, Neonate, Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Alkaline phosphatase (ALP) 10 13 http://ijca.iums.ac.ir/browse.php?a_code=A-10-1-54&slc_lang=fa&sid=1