scholarly journals Frequency of Hyperbilirubinemia at 72 Hours of Life in Term Newborns with a High-Intermediate Risk Serum Bilirubin Level At 48 Hours of Life

2018 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Bilirubin Level ◽  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Early Recognition ◽  
Serum Bilirubin Level ◽  
University Hospital ◽  
Total Serum ◽  
Intermediate Risk ◽  
Risk Zone ◽  
Term Newborns

Neonatal jaundice is common in newborns affecting over half (50-60%) of all babies in the first week of life. Severe jaundice can result into significant morbidity in the form of kernicterus. Early screening along with, quick treatment of neonatal jaundice helps to reduce the risk of developing severe hyperbilirubinemia, hence Kernicterus. There is strong evidence that screening newborns with hour-specific serum bilirubin level measurements can help in identifying risk of developing hyperbilirubinemia in newborns. There is insufficient data from developing countries regarding hyperbilirubinemia and newborns with and without underlying risk factors for hyperbilirubinemia. This cross sectional study will help the physician to anticipate and manage newborns with high-intermediate zone total serum bilirubin (TSB) and will also help to established specific management guideline for these newborns to prevent bilirubin induced neurological damage (BIND). All term newborns of either gender (fulfilling inclusion criteria) with TSB level at high-intermediate risk zone at 48 hours of life, born at Aga Khan University Hospital were included in this study. Their demographics were recorded in structured proforma. Results were collected and analyzed by SPSS software, version 20.0. A total of 173 newborns were enrolled. There was a female predilection 56.6% (n=98). One-third of the newborns having TSB in high-intermediate risk zone at 48 hours of life progressed to level of significant hyperbilirubinemia requiring treatment (31.2%; n=54). Those who required phototherapy had the mean rate of rise of 5.00 mg/dL/day (0.20 mg/dL/ hr). For future implementations we recommended that early recognition, monitoring and early treatment of neonatal hyperbilirubinemia may help in reducing morbidity. Neonates with high-intermediate risk serum bilirubin level should be followed at 24 hours intervel for assessment and possible treatment.

scholarly journals Study of cord blood albumin as a predictor of neonatal jaundice

2020 ◽  
Vol 11 (4) ◽  
pp. 58-63
Author(s):  
Pabitra Sapkota ◽  
Fakir Chandra Gami
Keyword(s):  
Cord Blood ◽  
Bilirubin Level ◽  
Neonatal Jaundice ◽  
Albumin Level ◽  
Serum Bilirubin Level ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Total Serum Bilirubin Level ◽  
Term Newborns ◽  
Blood Albumin

Background: Neonatal jaundice is a commonly encountered condition in the neonates during first week of life. Early discharge of healthy term newborns is a common practice, because of the risk of nosocomial infections, social causes like in early naming ceremony, and also due to economical constrains. In significant number of newborns, neonatal hyperbilirubinemiais the most common cause for readmission. There is concern regarding early discharge of healthy term newborns due to reports of bilirubin induced brain damage resulting in sequel like kernicterus .There are reports of bilirubin induced brain damage  which occurred in healthy term neonates even without hemolysis and the clinical outcome could be serious. The need for early detection of hyperbilirubinemia in the newborns is therefore important. Aims and Objective: The objective of the study was to find whether cord blood albumin can be considered as a predictor of neonatal jaundice. The study also explored for any possible associations of different factors like gender, birth weight and mode of delivery with the occurrence of neonatal jaundice. Materials and Methods: The hospital based cross sectional study enrolled 100 healthy term newborns from August 2016-July 2017. Cord blood was sent for albumin level and blood group estimation. All babies were assessed for clinical jaundice using Krammer criteria and confirmed by estimation of total serum bilirubin level on the fourth day of life. Results: Correlation of cord blood albumin with the fourth day bilirubin level revealed negative correlation (r value of - 0.455) with p value of 0.000 which was highly significant. However, there was no correlation between cord blood albumin level with  total serum bilirubin level of more than 17mg/dl (neonatal hyperbilirubinemia) that required phototherapy or exchange transfusion (p value of >0.005). Similarly, the study found no statistically significant association of neonatal jaundice with gender, weight and mode of delivery of the neonates. Conclusion: Cord blood albumin can be a risk factor rather than a diagnostic tool which can give a clue to possibility of high bilirubin level during neonatal period. There was no statistical significance seen between cord blood albumin level with total serum bilirubin level of ≥ 17mg/dl (neonatal hyperbilirubinemia) that required phototherapy or exchange transfusion. 

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].

scholarly journals Glucose-6-Phosphate Dehydrogenase (G6PD) Status in Neonatal Jaundice and its Relationship with Severity of Hyperbilirubinemia

1970 ◽  
Vol 4 (2) ◽  
pp. 71-76
Author(s):  
Nilufa Akhter ◽  
Noorzahan Begum ◽  
Waqar Ahmed Khan
Keyword(s):  
Bilirubin Level ◽  
G6pd Deficiency ◽  
Serum Bilirubin ◽  
Serum Bilirubin Level ◽  
Total Serum ◽  
Control Group ◽  
Term Neonates ◽  
Group A ◽  
The Difference ◽  
Enzyme Deficient

Background: G6PD deficiency is one of the common inherited enzymatic disorder associated with high incidence of severe neonatal hyperbilirubinemia. Objectives: To observe G6PD status in male, term neonates with jaundice and its correlation with serum level of bilirubin. Methods: This cross sectional study was conducted on 90 male, term neonates with jaundice, age ranged from 3 to 12 days (Group B) in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU) between July 2007 to June 2008. On the basis of total serum bilirubin (TSB) level, study group was further divided into B1(TSB <15mg/dl), B2(TSB 15-20mg/dl) and B3 (TSB>20mg/dl). For comparison age and sex matched 30 apparently healthy neonates (Group A) were also included in the study. Erythrocyte G6PD level was measured by Spectrophotometric method by using kit of Randox. Serum bilirubin level was measured by standard laboratory technique. For statistical analysis ANOVA, independent sample "t" test and Pearson's correlation coefficient test were performed as applicable by using SPSS windows version-12. Results: In this study, erythrocyte G6PD levels were significantly lower in moderate (p<0.01) and severe (p<0.001) hyperbilirubinemic group in comparison to that of control group . However, this enzyme level was lower in mild group compared to that of control but the difference was statistically non significant. Again, this enzyme levels were significantly lower in moderate (p<0.05) and severe (p<0.01) group than that of mild group and also between severe and moderate hyperbilirubinemic group (p<0.05). In this study, G6PD enzyme deficient were found in 1(3.33%) and 6(20%) subjects of group B2 and B3 respectively. Though, percentage of the subjects with enzyme deficiency were higher in severe group ( B3 ) compared to that of moderate group( B2 ) but the difference was statistically not significant. However, no enzyme deficient patient were found in control group (A) and mild hyperbilirubinemic group (B1). Serum bilirubin level showed significant (p<0.05) positive (r=+.429) correlation with erythrocyte G6PD level in control group (A). On the other hand, this level was negatively correlated with G6PD enzyme in groups B1 (r= -.127), B2 (r=-.120) and B3 ( r= -.671) but significant negative correlation in group B3 (p<0.01). Conclusion: The results of the study revealed that severity of hyperbilirubinemia depends on degree of G6PD deficiency. Therefore, early detection of this enzymopathy and close surveillance of the affected neonates may be important in reducing the complications of severe hyperbilirubinemia. Key words: Glucose-6-PD, Hyperbilirubinemia, Neonates DOI: 10.3329/jbsp.v4i2.4176 J Bangladesh Soc Physiol. 2009 Dec;4(2): 71-76  

scholarly journals Associations between Neonatal Serum Bilirubin and Childhood Obesity in Term Infants

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Lile Zou ◽  
Huan Yu ◽  
Yuan He ◽  
Lijuan Luo ◽  
Wenbin Dong ◽  
...  
Keyword(s):  
Childhood Obesity ◽  
Regression Models ◽  
Serum Bilirubin ◽  
Estimating Equation ◽  
Serum Bilirubin Level ◽  
Total Serum ◽  
Generalized Estimating Equation ◽  
Term Infants ◽  
Logistic Regression Models ◽  
Term Newborns

Abstract Inverse correlations between serum bilirubin level and obesity had been reported in adults. We aimed to investigate the associations between neonatal hyperbilirubinemia and childhood obesity. Data was obtained from the U.S. Collaborative Perinatal Project (CPP), a multicenter study from 1959 to 1976. Data of serum bilirubin in term newborns were used to observe the association with obesity at age of 7 years. Logistic regression models were performed to calculate adjusted odds ratios (aORs) for obesity. For children from the same mother sharing similar factors, Generalized Estimating Equation (GEE) model was used to correct for intracluster correlation. Relative to newborns with total serum bilirubin (TSB) < 3 mg/dl, there are lower risks for obesity in those with 3 mg/dl ≤ TSB < 6 mg/dl (aOR 0.91; 95%CI 0.81, 1.02), 6 mg/dl ≤ TSB < 9 mg/dl (aOR 0.88; 95%CI 0.78, 0.99), 9 mg/dl ≤ TSB<13 mg/dl (aOR 0.83; 95%CI 0.71, 0.98). By stratifying for subtypes of bilirubin, the inverse correlations only existed in exposure to unconjugated bilirubin. By using the GEE model correcting for intracluster correlations, the results are consistent. In summary, exposure to bilirubin up to 13 mg/dl is inversely associated with obesity at the age of 7 years in term infants.

scholarly journals Effect of Time of Cord Clamping on Serum Bilirubin Level among Full Term Babies Born at Tikur Anbessa Specialized Hospital: A Three Arm Randomized Control Trial.

2021 ◽  
Author(s):  
Biruk Hailu Tesfaye ◽  
Mulugeta Betre Gebremariam ◽  
Abiy Seifu Estifanos ◽  
Asrat D. Gebremedhin
Keyword(s):  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Tertiary Care ◽  
Serum Bilirubin Level ◽  
Full Term ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Care Hospital ◽  
Delayed Cord Clamping ◽  
Cord Clamping

Abstract Background: Delayed cord clamping (DCC) above one minute is associated with nutritional and developmental benefits newborns. DCC could also lead to elevated serum bilirubin, leading to jaundice that require phototherapy at the early ages of life. However, evidence on the relationship between DCC and outcomes is limited in resource-limited settings.Objective: To evaluate the effect of the time of cord clamping on serum bilirubin level at 24 hours post-birth in an Ethiopian Tertiary Care hospital.Methods: A three-arm, single-blind, randomized controlled trial was conducted between October 2019-January 2020 targeting healthy, full-term neonates. Study participants were randomly assigned into one of the following interventions depending on the timing of cord clamping: immediate cord clamping (<30 seconds), intermediate cord clamping (60 sec), and delayed cord clamping (180 seconds). The primary outcome is serum bilirubin level in the newborns, which was assessed at 24-hour after birth and before they were discharged home. Descriptive analysis was applied to assess differences between groups in terms of demographic, obstetric, and social characteristics of participants, while linear regression model was employed to examine the association between cord clamping time and serum bilirubin level. STATA version 14 was used for statistical analyses.Result: A total of 141 term newborns were included and randomized into the three categories. Demographic, social and obstetrics factors of the women were not different across groups except labor duration that had a P-value < 0.05. Time of cord clamping was not a significant predictor of total serum bilirubin levels at 24 hours post-birth, whereas cord blood total serum bilirubin (coef. 0.24; p<0.05) and bilirubin nomogram high-risk zone (Coef. 6.25; p<0.001) were significant predictors.Conclusion: Time of umbilical cord clamping has no effect on the total serum bilirubin level of neonates at least within 24 hours of birth.

Double Versus Single Phototherapy in Low Birth Weight Newborns

PEDIATRICS ◽  
1992 ◽  
Vol 90 (5) ◽  
pp. 674-677
Author(s):  
Paul C. Holtrop ◽  
Kathleen Ruedisueli ◽  
M. Jeffrey Maisels
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Elevated Serum ◽  
Threshold Level ◽  
Serum Bilirubin Level ◽  
Total Serum ◽  
The Difference ◽  
To Receive

Conventional phototherapy systems that simultaneously irradiate the front and the back of the baby lower the serum bilirubin level more rapidly than one-sided systems, but they are impractical. Fiberoptic phototherapy makes it easy to administer conventional phototherapy from above while the infant lies on a fiberoptic phototherapy blanket. Newborns with birth weights less than 2500 g were randomly assigned to receive either single (n = 37) or double (n = 33) phototherapy. The groups were similar in clinical and laboratory characteristics. After 18 hours of therapy the serum bilirubin concentration declined by 31 ± 11% in the double and 16 ± 15% in the single phototherapy group (2.9 ± 1.1 vs 1.6 ± 1.4 mg/dL), and the difference in the total serum bilirubin levels after 18 hours of therapy was significant (double phototherapy group 7.1 ± 2.7 mg/dL vs single phototherapy group 8.2 ± 2.6 mg/dL). After 18 hours of treatment the serum bilirubin level was less than the phototherapy threshold level in 26 of 37 single phototherapy patients vs 32 of 33 double phototherapy patients. Double phototherapy was well tolerated. It is concluded that this type of double phototherapy is more effective than single phototherapy in low birth weight newborns. Double phototherapy may be useful when it is necessary to reduce an elevated serum bilirubin level as rapidly as possible or when the bilirubin level is rising with single phototherapy.

Superiority of Oral Agar and Phototherapy Combination in the Treatment of Neonatal Hyperbilirubinemia

PEDIATRICS ◽  
1993 ◽  
Vol 92 (1) ◽  
pp. 86-89
Author(s):  
Suat Caglayan ◽  
Halil Candemir ◽  
Sadik Aksit ◽  
Savas Kansoy ◽  
Sezin Asik ◽  
...  
Keyword(s):  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Single Agent ◽  
Serum Bilirubin Level ◽  
Neonatal Hyperbilirubinemia ◽  
Treatment Modalities ◽  
Combination Group ◽  
Control Group ◽  
Term Newborns ◽  
Time Required

Objective. To determine the value of oral agar in the treatment of neonatal hyperbilirubinemia and to compare it with two other treatment modalities: phototherapy alone and phototherapy plus oral agar. Methods. Two hundred eight jaundiced full-term newborns were divided into four groups. They were given either phototherapy alone, phototherapy plus oral agar, oral agar alone, or no treatment (control group). The changes in the serum bilirubin values were determined and the results were compared statistically, mainly using analysis of variance. Results. In all three therapy groups, the time required to reduce the bilirubin level to either 15 mg/dL or to 10 mg/dL was significantly shorter than that required by the control group. Although oral agar was found to be as effective as phototherapy, the most significant decrease in bilirubin level was in the combination group. Conclusions. The efficacy of phototherapy in decreasing the serum bilirubin level in neonatal hyperbilirubinemia can be augmented with the use of oral agar. Oral agar can also be used as a single agent for the treatment of neonatal hyperbilirubinemia, since it is as effective as phototherapy.

Neonatal Jaundice—A Comparison between Intravenous Oxytocin and Oral Prostaglandin E2

1976 ◽  
Vol 4 (4) ◽  
pp. 241-246 ◽  
Author(s):  
D I Conway ◽  
M D Read ◽  
C Bauer ◽  
R H Martin
Keyword(s):  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Active Agent ◽  
Serum Bilirubin Level ◽  
Significant Rise ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Prostaglandin E ◽  
Total Serum Bilirubin Level ◽  
Spontaneous Onset

The total serum bilirubin levels at two and occasionally five days after birth were studied in 162 infants whose mothers received either intravenous oxytocin or oral Prostaglandin E2 during labour, and the results were compared with those obtained in forty-two control patients. Following labour of spontaneous onset, whether the mother received intravenous oxytocin or oral Prostaglandin E2, neonatal total serum bilirubin levels were not different from those in controls. After induction by amniotomy and an active agent, higher mean total serum bilirubin levels were found in infants whose mothers received intravenous oxytocin than in those given oral Prostaglandin E2; a significant rise in the total serum bilirubin level appeared to occur when mothers received a total of more than 12,000 milliunits of oxytocin or more than 4,000 milliunits per kg birthweight of the infant.

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