scholarly journals Effects of season of birth and meteorological parameters on serum bilirubin levels during the early neonatal period: a retrospective chart review

2020 ◽  
Author(s):  
Shigeo Iijima ◽  
Toru Baba ◽  
Miyuki Kondo ◽  
Tomoka Fujita ◽  
Akira Ohishi
Keyword(s):  
Neonatal Jaundice ◽  
Meteorological Parameters ◽  
Serum Bilirubin ◽  
Cold Season ◽  
Total Serum ◽  
Season Of Birth ◽  
Male Population ◽  
Female Population ◽  
Term Neonates ◽  
Significant Difference

Abstract Background: Neonatal jaundice can be influenced by many factors. Several studies have suggested that the severity of neonatal jaundice may vary with the season, but conclusive data on this issue are currently lacking. The aim of the present study was to establish whether serum bilirubin levels vary in healthy term neonates according to seasonal variation and meteorological factors.Methods: We retrospectively studied 3,344 healthy term neonates born between 2013 and 2018. Using the capillary technique, total serum bilirubin (TSB) levels were measured on the fourth day after birth. The monthly and seasonal variations in TSB levels and clinical and meteorological effects on TSB levels were assessed.Results: In the enrolled neonates, the median gestational age was 39.4 weeks, median birthweight was 3,025 g, and median TSB level was 195 µmol/L. The TSB level peaked in December and was the lowest in July, but the variation was not statistically significant. The TSB level was significantly higher in the cold season (October to March) than in the warm season (April to September; p=0.01). Comparing the seasonal differences according to sex, TSB levels were significantly higher in the cold season in male infants (p=0.001), whereas no significant difference was observed in female infants. In only the male population did a weakly negative but significant association exist between TSB levels and daily mean air temperature (r=-0.07, p=0.007); in the female population, no significant correlation was found between TSB levels and meteorological parameters.Conclusions: Season of birth appears to be an etiological factor in neonatal jaundice, with an additional influence of sex. However, the contradictions observed in various studies highlight the need for further research on this topic.

scholarly journals Effects of Season of Birth and Meteorological Parameters on Serum Bilirubin Levels during the Early Neonatal Period: A Retrospective Chart Review

2021 ◽  
Vol 18 (5) ◽  
pp. 2763
Author(s):  
Shigeo Iijima ◽  
Toru Baba ◽  
Miyuki Kondo ◽  
Tomoka Fujita ◽  
Akira Ohishi
Keyword(s):  
Seasonal Variations ◽  
Meteorological Parameters ◽  
Serum Bilirubin ◽  
Warm Season ◽  
Total Serum ◽  
Season Of Birth ◽  
Male Population ◽  
Female Population ◽  
Term Neonates ◽  
Significant Difference

To establish whether serum bilirubin levels vary in healthy term neonates according to seasonal variations and meteorological factors, we retrospectively studied 3344 healthy term neonates born between 2013 and 2018. Total serum bilirubin (TSB) levels were measured on the fourth day after birth. The monthly and seasonal variations in TSB levels and clinical and meteorological effects on TSB levels were assessed. In the enrolled neonates, the median TSB level was 195 µmol/L. The TSB level peaked in December and was the lowest in July, but the variation was not statistically significant. The TSB level was significantly higher in the cold (October to March) than in the warm season (April to September; p = 0.01). The comparison between seasonal differences according to sex showed TSB levels were significantly higher in the cold than in the warm season in male infants (p = 0.001), whereas no significant difference was observed in female infants. A weakly negative but significant association existed between TSB levels and the mean daily air temperature (r = −0.07, p = 0.007) in only the male population; the female population showed no significant correlation between TSB levels and meteorological parameters. The season of birth is an etiological factor in neonatal jaundice, with an additional influence from sex.

EFFECT OF PHOTOTHERAPY ON SERUM CALCIUM LEVELS IN NEONATAL JAUNDICE

2021 ◽  
pp. 17-19
Author(s):  
Aradhana Gupta ◽  
Anand Kumar Bhardwaj ◽  
Anisha Aggarwal ◽  
Gauri Chauhan
Keyword(s):  
Serum Calcium ◽  
Neonatal Intensive Care ◽  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Calcium Supplementation ◽  
Clinical Signs ◽  
Total Serum ◽  
Medical Sciences ◽  
Term Neonates ◽  
Unconjugated Hyperbilirubinemia

Background :To study the effect of phototherapy on serum calcium levels in neonates with unconjugated hyperbilirubinemia. Methods : This hospital based longitudinal interventional study was conducted on 100 neonates with neonatal hyperbilirubinemia admitted to Neonatal Intensive Care Unit at Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala. Total serum bilirubin and serum calcium levels of each participants were checked before and at the end of phototherapy. Neonates were also checked for the clinical signs of hypocalcemia i.e. jitteriness, irritability, lethargy, and convulsions. Results : Atotal of 100 neonates with neonatal jaundice were included with 55% boys and 45 % girls whose mean age was 3.0 ± 0.95 days. Mean S.Bilirubin level before phototherapy was 13.92 ± 2.32 mg/dl which was reduced to 8.87 ± 2.18 mg/dl. S.Calcium levels pre-phototherapy were 8.66 ± 0.65 mg/dl which were reduced to 7.94 ± 1.05 mg/dl. It was found that 32% of the participants in total exhibited symptoms related to hypocalcemia. More term neonates (56.3%) experienced symptoms related to hypocalcemia compared to pre-terms (43.8%). Conclusion : It can be deduced that phototherapy induced hypocalcemia is a signicant concern and hence, neonates requiring phototherapy may be considered for calcium supplementation.

Efficacy and Safety of Fenofibrate in Uncomplicated Hyperbilirubinemia in Newborn: A Randomized Trial, with a 6-month Follow-up

2020 ◽  
pp. 37-42
Author(s):  
Jayendra R. Gohil ◽  
Vishal S. Rathod ◽  
Bhoomika D. Rathod
Keyword(s):  
Single Dose ◽  
Serum Bilirubin ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Control Group ◽  
Term Neonates ◽  
Significant Difference ◽  
Group A ◽  
Group B

Objective: To study the effect and safety of Fenofibrate in uncomplicated hyperbilirubinemia in newborn with 6-month follow-up. Materials and Methods: This is a randomized controlled clinical trial conducted in 60 normal term neonates admitted for uncomplicated hyperbilirubinemia in NICU at Sir T G Hospital, Bhavnagar from January 2012 to December 2012. The data included: age, sex, total serum bilirubin (TSB), weight and duration of phototherapy. All neonates enrolled in the study received phototherapy. They were divided in two groups of 30 each: control group A and group B receiving Fenofibrate (100 mg/kg single dose). There was statistically insignificant difference between the parameters of age, sex, weight and TSB between the two groups at hospitalization. Data was analyzed by using appropriate statistical methods. Results: Mean values for total serum bilirubin in Fenofibrate group B at 24 and 48 hours after admission were significantly lower than those for control group A (p<0.0001,  p=0.0001). There was no significant difference in fall of TSB between 24 and 48 hours. The mean duration of phototherapy in Fenofibrate group (44.8h: 24-72h) was significantly shorter than that in control group (55.2 h: 24‐96 h) (P=0.02). There were no side effects of the drug observed during the study and during 6 months follow up period. Conclusion: Fenofibrate as a single 100 mg/kg dose in healthy full term neonates, is effective and a safe drug (till six-month follow-up) for neonatal hyperbilirubinemia, that can decrease the time needed for phototherapy and hence hospitalization. Effect of a single dose seems to wane after 24 hours.

Super LED Lamps and Compact Fluorescent Lamps in the Management of Neonatal Jaundice

2018 ◽  
Vol 20 (2) ◽  
Author(s):  
Patricia O Onianwa ◽  
Iyanuoluwa Oreofe Adubi ◽  
Temitope O Alonge ◽  
Abiodun Jesse Otegbayo ◽  
Olaoluwa S Yaya ◽  
...  
Keyword(s):  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Light Sources ◽  
Male And Female ◽  
Led Phototherapy ◽  
Fluorescent Lamps ◽  
Compact Fluorescent Lamps ◽  
Significant Difference

Neonatal jaundice is a colossal issue worldwide, particularly in developing countries. About 60 per cent of term and 80 per cent of preterm babies develop jaundice during the first week of life. Approximately 5–10 per cent of all newborns need phototherapy to prevent this commonest morbidity in neonatal life. The commonly used light sources are special blue fluorescent tubes, compact fluorescent tubes and halogen spotlights. In recent years, a new type of light source, light-emitting diodes (LEDs), has been incorporated into phototherapy. It assessed the significant difference between the baseline total and the level of bilirubin for the first four days of using compact fluorescent lamps (CFLs) and super LED phototherapy lamps. It also examined the significant difference in the responses of male and female neonates to the two intervention methods as well as the significant difference in the median weights of neonates on the day of discharge based on the two intervention methods. The count of the baseline total serum bilirubin when using LED lamps was 11.71 and 8.86 when using CFL lamps. The total serum bilirubin count when using LED lamps decreased from 11.12 to 5.30, and from 9.11 to 6.32 when using CFLs. However, there was no significant difference in the responses of male and female neonates to the two intervention methods and the median weights of neonates on the day of discharge.

Effect of Neonatal Phototherapy on Eosinophil Levels in Nonsevere Hyperbilirubinemia

2019 ◽  
Vol 37 (09) ◽  
pp. 929-932
Author(s):  
Ceren Can ◽  
Şahin Hamilcıkan
Keyword(s):  
Serum Bilirubin ◽  
Total Serum ◽  
Female Ratio ◽  
Term Neonates ◽  
Significant Difference ◽  
Delivery Route ◽  
Cell Series ◽  
The Impact ◽  
Male To Female ◽  
Spontaneous Delivery

Objective The purpose of the research was to determine the impact of phototherapy (PT) on eosinophil levels in neonates with nonsevere bilirubin levels (<20 mg/dL) treated with PT. Study Design This observational pilot study included term neonates with early neonatal hyperbilirubinemia. Results Ninety-six term neonates were included in the study. The male-to-female ratio was 1.23. Hyperbilirubinemia was most frequently related to ABO group incompatibility (49%). Fifty-two neonates (54.1%) were born by normal spontaneous delivery. After PT, while total serum bilirubin, hemoglobin, hematocrit, leukocyte, and neutrophil levels were found to be significantly decreased, eosinophil levels were significantly increased (p = 0.01). No significant difference was found regarding lymphocyte and basophil levels after PT. A statistically significant correlation was found between bilirubin and eosinophil levels before PT (r 2 = 0.28, p = 0.03). No correlation between eosinophil levels and treatment age, gender, diagnosis of hyperbilirubinemia, and delivery route before PT was found. After PT, eosinophil levels increased, while other blood cell series were found to be decreased. The correlation between the bilirubin levels and eosinophil was found to be negative (r 2 = − 0.32, p = 0.02) after PT. Conclusion PT may increase serum eosinophil levels in term neonates with nonsevere hyperbilirubinemia.

scholarly journals EFFECT OF PHOTOTHERAPY ON SERUM CALCIUM LEVELS IN NEONATAL JAUNDICE IN FULL TERM NEONATES

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Ashish Kumar
Keyword(s):  
Standard Deviation ◽  
Serum Calcium ◽  
Neonatal Jaundice ◽  
Calcium Concentration ◽  
Full Term ◽  
Total Serum ◽  
Close Monitoring ◽  
Term Neonates ◽  
Unconjugated Hyperbilirubinemia ◽  
Significant Difference

Introduction: The most prevalent anomalous physical finding during the first week of life is neonatal hyperbilirubinemia (NNH). It is estimated that more than two thirds of newborn babies have acquired clinical jaundice. It was also discovered that in the unconjugated hyperbilirubinemia of most neonates represents a common or exaggerated physiological syndrome. The physical immaturity of infants to handle increased production of bilirubin is referred to as Jaundice. This becomes potentially neurotoxic if severe unconjugated hyperbilirubinemia is left untreated. One of the routine strategies for treating hyperbilirubinemia is known as phototherapy. However it is not a harmless interference. This can produce negative results, such as dehydration, temperature volatility, blood flow redistribution, genotoxicity, rashes on the skin, loose skin, stools, damage to retinas, hypocalcemia and bronze baby syndrome. One of the lesser known but which has a potential adverse effect of phototherapy is hypocalcemia. A total serum calcium concentration of < 7 mg / dl or ionised calcium concentration < 4mg / dl (< 1mol / L) is classified as neonatal hypocalcemia. Hypocalcemia increases the permeability of cells to sodium ions and increases the excitability of cell membranes. Material & Methods: 60 full term neonates were included in present cross sectional study who was admitted to Neonatal Intensive Care Unit (NICU). Full term neonates who completed 37 weeks of gestation with unconjugated hyperbilirubinemia who require phototherapy. Under the normal protocol, traditional phototherapy equipment containing four blue light fluorescent lamps with wavelengths of 410-470 nm was mounted at a distance of 25-35 cm from the skin surface of neonates with entirely covered eyes and genitals. At 15μW / cm2 /nm at the level of the infant's skin, the irradiance during phototherapy was assessed and maintained consistently. Results: Among 60 neonates included in this study there were 27 (45%) male whereas 33 (55%) female neonates. In present study the mean levels of serum calcium before phototherapy was 9.21 with standard deviation of 0.83 while the serum calcium levels after phototherapy were 8.36 with standard deviation of 0.78. There was a statistically significant difference between serum mean calcium levels before and after phototherapy (p=0.001). Conclusion: A major issue is phototherapy induced hypocalcemia. Before beginning and during phototherapy for neonatal jaundice and close monitoring of neonates for signs of hypocalcemia, careful calcium status calculation should be carried out.. After phototherapy, there is a substantial reduction in the amount of serum calcium, but the risk of hypocalcemia in stable full-term neonates is minimal.

Role of Cord Blood Carboxyhemoglobin in Detecting Significant Hyperbilirubinemia in Term Neonates with ABO Alloimmunization

2021 ◽  
Author(s):  
Mahir Tıraş ◽  
Emrah Can ◽  
Şahin Hamilçıkan
Keyword(s):  
Cord Blood ◽  
Total Serum ◽  
Healthy Controls ◽  
Term Neonates ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Positive Direct ◽  
Severe Hyperbilirubinemia

Objective This study aimed to assess whether cord blood carboxyhemoglobin (COHb) levels in jaundiced term neonates with and without a positive direct Coombs test (DCT) and in healthy controls could be used as a predictor of severe hyperbilirubinemia. The percentage of cord blood COHb should be higher among neonates with Coombs-positive ABO hemolytic disease than among those with Coombs-negative ABO incompatibility and higher than that of ABO-compatible control neonates. Study Design This cross-sectional descriptive study of 198 term neonates comprised three subgroups: group I featured 68 DCT-positive ABO-incompatible neonates (ABO + DCT), group II featured 60 DCT-negative ABO-incompatible neonates with hyperbilirubinemia (ABO–DCT), and group III featured 70 healthy controls. COHb was determined by an OSM3 hemoximeter. Results Group I differed from groups II and III for cord blood bilirubin, cord blood hemoglobin, and cord blood hematocrit. Groups I and II had higher mean total serum bilirubin (TSB) levels than group III, while there was no difference in the mean TSB levels between groups I and II. There was no significant difference between the COHb group means for groups I, II, and III (p = 0.98). The area under the receiver operating characteristic curve calculated for group I/group III and group II/group III were found to be 0.62 and 0.54, respectively. Conclusion COHb levels did not prove to be superior to the DCT for predicting the risk of developing severe hyperbilirubinemia in term neonates. Key Points

scholarly journals Transcutaneous billirubinometry to estimate total serum bilirubin in neonatal jaundice

2017 ◽  
Vol 57 (1) ◽  
pp. 8 ◽  
Author(s):  
Andra Kurnianto ◽  
Herman Bermawi ◽  
Afifa Darmawanti ◽  
Erial Bahar
Keyword(s):  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Subcutaneous Tissue ◽  
Correlation Coefficients ◽  
Total Serum Bilirubin ◽  
Blood Sampling ◽  
Total Serum ◽  
Transcutaneous Bilirubin ◽  
Non Invasive ◽  
Transcutaneous Bilirubinometry

Background The gold standard for diagnosis of neonatal jaundice is total serum bilirubin (TSB) measurement. This method, however, is invasive, painful, and costly in terms of workload, time, and money. Moreover, repeated blood sampling may lead to significant blood loss, which is of particular concern in preterm infants. To overcome these drawbacks, non-invasive methods of bilirubin measurement have been proposed. Transcutaneous bilirubinometry (TcB) determines the yellowness of the subcutaneous tissue of a newborn infant by measuring the difference between optical densities for light in the blue and green wavelength regions.Objective To evaluate the accuracy of transcutaneous bilirubinometry for estimating TSB levels in neonatal jaundice.Methods Subjects were infants aged < 28 days with jaundice who had never been treated with phototherapy or exchange transfusion. The study was done from February to July 2016 in Mohammad Hoesin Hospital. Subjects underwent transcutaneous bilirubin (TcB) and TSB assays, with a maximum interval of 15 minutes between tests.Results One hundred fifty patients were included in this study. The TcB values > 5 mg/dL were correlated to TSB > 5 mg/dL, with 100% sensitivity and 83.3% specificity. This cut-off point was obtained from a receiver-operator characteristic (ROC) curve with AUC 99.3% (95%CI 97.9 to 100%; P< 0.001).The correlation coefficients (r) for TSB and TcB measurements on the forehead were 0.897 (P<0.001).Conclusion Transcutaneous bilirubinometry can be used to accurately estimate TSB levels in neonatal jaundice, and may be useful in clinical practice as a non-invasive method to reduce blood sampling.

Effect of Addition of Probiotics to Standard Treatment on Neonatal Jaundice

2021 ◽  
Vol 17 (2) ◽  
pp. 199-203
Author(s):  
Tehreem Afzal ◽  
Naveed Butt ◽  
Shahzad Munir ◽  
Nazish Zia
Keyword(s):  
Bilirubin Level ◽  
Neonatal Jaundice ◽  
Standard Treatment ◽  
Serum Bilirubin ◽  
Serum Bilirubin Level ◽  
Combination Group ◽  
Medical Institute ◽  
Significant Difference ◽  
The Mean ◽  
Time Required

Objective: To compare the mean change in the bilirubin levels with addition of probiotics to standard treatment for the management of neonatal jaundice. Methodology: The randomized controlled trial was undertaken at the Neonatal Intensive Care Unit of the Paediatrics Department, Federal Government Polyclinic (Post Graduate Medical Institute), Islamabad from 1st April to 30th September 2019.  Neonates with hyperbilirubinemia requiring phototherapy were randomly divided into two groups, each having 30 patients. Group A received probiotics along with phototherapy while group B received phototherapy alone. Primary outcome was serum total bilirubin, which was calculated on 0, 1 and 3 days of treatment. Duration of phototherapy and patient's outcome was also recorded. Data was analyzed statistically using SPSS v. 23. Results: The mean serum bilirubin level after 24 hours was 14.27 ± 4.35 mg/dl in combination group while 16.43 ± 4.36 mg/dl in phototherapy group (p > 0.05). After 48 hours, the mean serum bilirubin level was 12.37 ± 3.33 mg/dl in combination group while 14.09 ± 3.60 mg/dl in phototherapy group (p > 0.05). After 72 hours, the mean serum bilirubin level was 11.09 ± 2.87 mg/dl in combination group while 11.72 ± 2.96 mg/dl in phototherapy group (p > 0.05). The mean time required of blue light phototherapy was 43.47 ± 20.71 hours in combination group while 61.53 ±28.27 hours in phototherapy group (p < 0.05). All neonates were discharged. Conclusion: Addition of probiotics to standard treatment decreased the time required for the phototherapy in neonatal jaundice. However no statistically significant difference was seen in the bilirubin levels between the two groups.

scholarly journals Effectiveness of phototherapy with reflecting curtains on neonatal jaundice

2011 ◽  
Vol 51 (5) ◽  
pp. 256 ◽  
Author(s):  
Ari Kurniasih ◽  
Guslihan Dasa Tjipta ◽  
Muhammad Ali ◽  
Emil Azlin ◽  
Pertin Sianturi
Keyword(s):  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Low Cost ◽  
Total Serum Bilirubin ◽  
Spectral Irradiance ◽  
Total Serum ◽  
Control Group ◽  
Study Group ◽  
Term Newborns ◽  
The Mean

Background Although phototherapy has been used in clinical practice for 40 years, there is still much debate on how to provide the most efficacious phototherapy. Phototherapy with white reflecting curtains may increase the average spectral irradiance provided, as well as decrease serum bilirubin concentrations at a faster rate in neonates with jaundice.Objective To determine if adding low cost, white, reflecting curtains to a standard phototherapy unit can increase the effectiveness of phototherapy for neonatal jaundice.Methods A randomized, controlled, open trial was conducted at H. Adam Malik and Pirngadi Hospitals, Medan, from May to December 2009. The criteria for inclusion in the study were full term newborns with neonatal jaundice presenting in their first week of life. Single phototherapy with white curtains hanging from the sides of the phototherapy unit (study group, n=30) was compared to single phototherapy without curtains (control group, n=30). The primary outcomes measured were the mean difference in total serum bilirubin levels and average spectral irradiation levels measured at baseline, and after 12 hours and 24 hours of phototherapy.Results The sum of average spectral irradiance in the curtained phototherapy unit was significantly higher than that of the standard phototherapy unit without curtains (P < 0.05). The decrease of total serum bilirubin levels after 12 and 24 hours of phototherapy was significantly greater in the study group (3.71 and 9.7 mg/dl, respectively) than in the control group (0.1 and 3.8 mg/dl, respectively), both P <0.05.Conclusion White, reflecting curtains in phototherapy units was significantly more effective than phototherapy without curtains for treatment of neonatal jaundice. [Paediatr Indones. 2011;51:256-61].

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