Natural history and predictive risk factors of prolonged unconjugated jaundice in the newborn (original) (raw)
Related papers
Pediatrics International, 2010
Background: This study aimed to investigate the natural course and risk factors for prolonged unconjugated jaundice (PUJ) in neonates.Methods: This was a prospective descriptive study conducted in a tertiary care referral hospital of Northern India. The study included neonates who presented with clinical jaundice beyond 14 days of age. A detailed history, clinical examination and investigations were performed in all. All were followed till the normalization of clinical jaundice or up to 8 weeks of age, whichever was earlier. The key outcome measure was time to normalization of PUJ. Predictive risk factors for PUJ were analyzed by comparing with matched controls. Regression analysis was done for independent predictive risk factors of PUJ.Results: A total of 71 infants presented with prolonged jaundice (PJ). Out of these, 66 infants (93%) had PUJ. Glucose-6-phosphate dehydrogenase (G6PD) deficiency was the most commonly identified association of PUJ (24%). The median duration of jaundice in infants with PUJ was 5 weeks (range: 5–8). PJ in siblings (OR 2.9 [1.1–7.6]), oxytocin use during labor (OR 3.4 [1.1–10.4]) and G6PD deficiency (OR 4.0 [1.1–14.1]) were independent predictors of PUJ.Conclusions: Irrespective of the etiology, by 8 weeks, PUJ disappeared in all infants. G6PD deficiency was the most common association of PUJ. A history of PJ in siblings, use of oxytocin during labor and G6PD deficiency were independent predictors for PUJ.
International Journal of Contemporary Pediatrics, 2020
Background: Etiology of hyperbilirubinemia is not only crucial for optimal management of the patient but also it may have implications for subsequent pregnancies. The objective of this study was to study the clinical profile and the underlying aetiological factors leading to neonatal jaundice in this rural setting of Kutch District, Gujarat, India.Methods: This prospective observational study was conducted in the neonatal intensive care unit (NICU) and Post Natal ward Gujarat Adani Institute of Medical Science, Bhuj, Kutch, Gujarat. Total of 150 cases were enrolled for the study. Blood grouping and Rh typing of baby and mother were done. Cord blood bilirubin and haemoglobin, direct coomb's test (DCT) and bilirubin monitoring were done whenever there was a setting for Rh incompatibility.Results: Among 150 neonates studied, majority had birth weight between 2501g and 3000g. Only 21 babies had birth weight <2.5kg (14%) (Table 2). Of the 150 neonates 85 were males and 65 were fem...
Journal of Enam Medical College, 2015
Background: Jaundice is very common in the neonatal period of life. Although it is not a major cause of mortality, it is an important cause of morbidity. So, assessment of the causes and risk factors of neonatal jaundice is very important.Objectives: The objectives of the study were to find out the causes of jaundice, its clinical features, evaluation of the outcome of current management strategy and complications encountered by the participating subjects following treatment.Materials and Methods: This prospective study was conducted in the Neonatal Unit of Rangpur Medical College Hospital (RpMCH) during July to December 2006. A total of 100 neonates having jaundice on admission or who developed jaundice following admission were included in the study. A number of investigations were done for the purpose of assessment of neonates and their icteric condition. The test statistics used to analyse the data were descriptive statistics, Chi-square (?2) and correlation tests.Results: In the...
2014
Neonatal jaundice is a very common disease in the neonatal period. Glucose-6-phosphate dehydrogenase enzyme deficiency decrease red blood cells (RBCs) membrane defense against oxidants and makes the patients prone to hemolysis and neonatal jaundice. Therefore, we arrange a cross sectional descriptive study to determine frequency of Glucose-6-phosphate dehydrogenase deficiency in neonates with jaundice and the age of presentation of jaundice in G6PD deficient neonates presented at Department of Nursery unit Khyber Teaching Hospital Peshawar. 292 jaundiced neonates of age 0 days to 28 days with clinically diagnosed jaundice. Investigations like serum bilirubin level, direct and indirect, blood groups of baby and mother, G6PD decolorization time, were done in every neonate with jaundice. Frequency of G6PD deficiency in jaundiced neonates was determined among these jaundiced neonates. Age of the onset of jaundice in the G6PD deficient neonates was also recorded. It is concluded from the results of our study that frequency of G6PD deficiency in neonates with jaundice in this study was 16%. Avoidance of oxidant chemicals and drugs later in life will prevent chronic hemolytic anemia and acute hemolytic crisis.
American Journal of Pediatrics, 2021
Introduction: Neonatal jaundice is one of the most common medical problems in healthy full-term infants during the immediate postnatal period. Neonatal jaundice is the most common cause of readmissions in hospitals in the neonatal period. In low-resource settings, where the majority of births occur outside facilities and access to monitoring and laboratory testing is limited, many of the proven diagnostic and treatment strategies are not available. Aim and objectives: The harmful effects of hyperbilirubinemia can be prevented by early recognition and prompt management of those at risk. This study was aimed to provide information on the risk factors and management associated with neonatal jaundice in a low-resource setting with the objective of identifying potentially modifiable risk factors to reduce the incidence and consequences of jaundice in neonates. Methodology: Patients of Jaundice admitted in pediatrics ward, Bhagat Phool Singh Government Medical College for a period of 4 months formed the sample population. Data included birth weight, gestational age, mother's age, the onset time of hyperbilirubinemia, the onset of breast feeding, history of formula feeding and technique of delivery. Lab data including CBC, bilirubin levels, blood group & Rh type of mother and neonates. Microsoft word and SPSS software were used for the analysis of the results. Results: Among 100 neonates with neonatal jaundice 19% of neonates were pre term. 89 neonates were given exclusive breastfeeding. 4 of them were given infant formula powder and the remaining 7 were fed on cow's milk. Gestational age <37 weeks was present in 19. Birth weight of 22 neonates was <2000g. 77% of them were born by vaginal delivery and 23% by caesarean section. In management of neonates, phototherapy was done in 89 neonates, 10 neonates were given conservative treatment and 1 was referred to higher center for exchange transfusion. Conclusion: Several known risk factors for neonatal jaundice were confirmed in this study. It is very essential for health care professionals to be aware of all potential risk factors so that the disease is detected and treated early. The LED phototherapy has decreased the need of exchange transfusion in neonatal jaundice.
Study of neonatal jaundice in a tertiary care centre of South India
Pediatric Review: International Journal of Pediatric Research, 2016
Hyperbilirubinemia is a common problem during the neonatal period occurring in up to 60% of term and 80% of preterm babies in the first week of life. Some of the most common causes of neonatal jaundice include physiological jaundice, breast feeding or non feeding jaundice, breast milk jaundice, prematurity and ABO incompatibility. Aims and objectives of study: To study the incidence, various risk factors in newborns with clinical jaundice progressing to jaundice needing treatment and to assess no of neonates requiring phototherapy & exchange transfusion in ASRAM hospital, during May 2013 to July 2014. Method: The present study was a prospective hospital based study involving all neonates who were born at ASRAM Medical College and Hospital, a tertiary care centre, Eluru, West Godavari District, Andhra Pradesh. Observation: Out of 560 newborns, 273 (48.8%) newborns developed clinical jaundice. Out of 273 newborns with clinical jaundice, 166 (61%) newborns developed physiological jaundice and 107 (39%) newborns developed non physiological jaundice requiring therepeutic intervention in the form of phototherapy or exchange transfusion. Conclusion: Present study concludes that the leading cause of pathological jaundice is breastfeeding jaundice, ABO incompatibility and prematurity.
Neonatal Jaundice Causal Factors: A Literature Review
Women, Midwives and Midwifery
Background: Jaundice (neonatal icterus), known as yellowish baby is a condition where the yellowing of the skin and sclera in newborns, due to increased levels of bilirubin in the blood (hyperbilirubinemia) which subsequently causes an increase in bilirubin in the fluid outside the cell (extracellular fluid). Jaundice is one of the contributors to infant morbidity in Indonesia because it can cause the baby's body to become limp, unwilling to suck, increased muscle tone, stiff neck, muscle spasms, convulsions, sensory disturbances, mental retardation, disability, and even death. Objective: This study aimed to review the evidence related to the factors causing jaundice in neonates. Method: This research method was a literature review study. Journal searches were carried out by applying online database such as ScienceDirect and PubMed. Author also used google scholar for search engine. The inclusion criteria in this study were journals published in 2015-2020 using Indonesian and En...
G6PD deficiency is known to be associated with neonatal jaundice, kernicterus and even death. G6PD is the first enzyme of the pentose phosphate pathway and catalyzes the conversion of glucose-6-phosphate to 6-phosphogluconolactone, with the concomitant reduction of nicotinamide adenine dinucleotide phosphate (NADP) to its reduced form (NADPH). Three hundred and twenty five neonatal blood samples were collected for the study between the ages of 1–10days of both sexes. About 4ml of blood sample was collected from newborn baby with jaundice, 2ml of blood sample was dispensed into di-potassium ethylenediaminetetracetic acid (K2EDTA) bottles for packed cell volume and haemoglobin estimation using haematology analyzer (sysmex model KX-21N) also K2EDTA blood sample was used for G6PD status determination, remaining 2ml of blood sample was dispensed into heparin bottles for bilirubin estimation. Out of 325 newborn babies with neonatal jaundice, 96(29.5%) were G6PD deficient; 57 were male and 39 were female. Mean± SD of total bilirubin (B1) andconjugated bilirubin(B2) were significantly (P<0.05) higher in G6PD- deficient participants compared with G6PD normal. Neonates should be screened for G6PD deficiency when family history, ethnic or geographic origin on the timing of the appearance of neonatal jaundice suggests the possibility of G6PD deficiency.
Risk factors and outcome of neonatal jaundice in a tertiary hospital
Ibrahim Medical College Journal, 2010
Neonatal jaundice is a common cause of newborn hospital admission. The risk factors, the characteristics and outcomes related to neonatal jaundice in Bangladesh has not been studied so far. This study addressed the outcomes, characteristics and risks of the jaundiced newborn admitted into hospital. The babies who had significant jaundice and required phototherapy and /or exchange transfusion were investigated. A detailed history of delivery with gestational age was noted and clinical examination of the admitted newborn was done. Birth weight was recorded. The investigations included complete blood count, ABO and Rh compatibility, serum bilirubin, glucose 6 phosphate dehydrogenase (G6PD), thyroid stimulating hormone (TSH) and ultrasonography (USG) of brain. The newborns were closely monitored for the prognosis. The requirement of individualized phototherapy and exchange transfusion were also noted. Finally, the outcomes were recorded. Overall, 60 (m v. f = 58.3 v. 41.7%) newborns wer...
Problems of Neonatal Jaundice in Indonesia
Paediatrica Indonesiana
This study revealed the incidence of neonatal jaundice in the Dr. Cipto Mangunkusumo Hospital Jakarta to be 32.1%, i.e 42.97% in low birth weight infants and 29.70% in fulllerm infants. No pathological basis was proven in many cases. The factors which may cause pathological jaundice according to the frequency are as follows: infections, anoxia and hypoxia, hemolysis due to G6PD deficiency, multiple factors and hypoglycemia etc. This study also revealed that 69.5% of jaundiced infants had bilirubin concentration of more than 10 mg%. Analysis of the factors showed that most of them were preventable.