scholarly journals Association between Thyroid Profile and Serum Bilirubin Levels in Term Neonates on Day 3 of Life

2020 ◽  
Vol 8 (2) ◽  
pp. 42-45
Author(s):  
Prahlad Kadambi ◽  
MA Ramprakash ◽  
Gandi Soujanya ◽  
L Sushanth Prabhath Reddy
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Serum Bilirubin ◽  
Positive Association ◽  
Serum Levels ◽  
Total Serum ◽  
Term Neonates ◽  
The Mean ◽  
Thyroid Profile ◽  
Serum Tsh

Background: Neonatal indirect hyperbilirubinemia is a common clinical scenario that manifests as jaundice in the first week of life. Studies have shown that the physiological peak of serum bilirubin (SBR) levels is highest at 72 hours of life as a result of which SBR is measured at  72 hours of life routinely. The American Academy of Pediatricians (AAP) recommends routine screening for congenital hypothyroidism within the first week of life for all neonates. In common practice, both parameters are assessed simultaneously at 72 hours of life. This study aims     to correlate thyroid Profile and serum bilirubin levels assessed in term neonates at 72 hours of life. Subjects and Methods: Our retrospective study included 105 term neonates born through cesarean-section at MMCHRI, Kanchipuram; between August 2018 and August 2019. Pre-term, neonates born to eclamptic, pre-eclamptic, diabetic, hypothyroid, Rh-incompatible mothers were excluded from the study. The data collected included Birth Weight, Gestational Age, Thyroid Profile (T3, T4, TSH), SBR (Total and Direct). Data were analyzed using SPSS v16. Results: The mean gestational age of the study population was 268.05  6.25 days, and mean birth weight was 2.997  0.36 kgs. The mean serum levels  of total bilirubin were 11.36 3.52 mg/dl. The mean serum fT3, fT4, TSH levels were 8.17 23.2 pg/ml, 2.16 1.68 ng/dl and 4.07 3.4 mIU/ml respectively. A positive association was noted between serum TSH and total serum bilirubin (r= 0.176, p = 0.067) but not statistically significant. Conclusion: Our study has not shown a significant association between serum TSH and SBRT in term neonates. However, the simultaneous assessment remains practical in practice.

scholarly journals Evaluation of Jaundice meter in the assessment of jaundice among Nigerian preterm neonates

1970 ◽  
Vol 42 (3) ◽  
pp. 194-198
Author(s):  
BO Kayode-Adedeji ◽  
JA Owa ◽  
GO Akpede ◽  
SO Alikah
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Serum Bilirubin ◽  
Objective Assessment ◽  
Total Serum Bilirubin ◽  
Preterm Neonates ◽  
Total Serum ◽  
Transcutaneous Bilirubin ◽  
The Mean ◽  
Transcutaneous Bilirubinometry

Background: The objective assessment of the severity of neonatal jaundice is Total Serum Bilirubin (TSB) determination, which requires multiple blood sampling. This has inherent problems, including risks of anaemia and infection. Transcutaneous Bilirubinometry (TcB) is a reliable, non-invasive alternative, however there is paucity of data on its performance in black preterm neonates.Objectives: To evaluate the correlation between transcutaneous bilirubin (TcB) and total serum bilirubin (TSB) among Nigerian preterm neonates, and to determine the parameters affecting the relationship.Method: Jaundiced preterm neonates delivered between 28 and 36 weeks of gestation admitted at the Irrua Specialist Teaching Hospital (ISTH), Nigeria were recruited . The TSB levels were determined by spectrophotometry while the corresponding TcB levels were obtained using Jaundice Meter (JM-103). The neonates were stratified into gestational age and birth weight groups.Results: A total of 189 paired TcB and TSB levels were obtained from 60 neonates. The Mean (sd) TcB level of 11.4 (3.1) mg/dl was significantly higher than the mean TSB level of 10.2 (2.8)mg/dl (p= 0.028). The overall correlation coefficient between TcB and TSB was 0.98 and it was not significantly affected by the gestational age, birth weight and bilirubin levels.Conc lusion: Transcutneous bilirubin strongly correlates with total serum bilirubin levels among Nigerian preterm neonates, irrespective of gestational age, birth weight and the degree of jaundice.Keywords: hyperbiliruinaemia, jaundice meter, Nigerian, preterm, neonates, transcutaneous bilirubinometry

scholarly journals Effect of early and delayed cord clamping on hemoglobin and hematocrit among full term neonates.

2021 ◽  
Vol 28 (08) ◽  
pp. 1114-1119
Author(s):  
Saqib Aslam ◽  
◽  
Sadaf Minhas ◽  
Muhammad Azhar Farooq ◽  
Beenish Bashir Mughal ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Full Term ◽  
P Value ◽  
Delayed Cord Clamping ◽  
Term Neonates ◽  
Cord Clamping ◽  
Significant Difference ◽  
Early Cord Clamping ◽  
The Mean

Objective: To compare the mean hemoglobin levels and frequency of polycythemia in full term neonates after early and delayed cord clamping. Study Design: Randomized Controlled Trial. Setting: KRL General Hospital Islamabad (Labor Room/ Neonatology). Periods: December 2017 to June 2018. Material & Methods: 190 full term neonates were selected and divided into 2 equal groups randomly: Early cord clamping group after delivery and late cord clamping group. Two hours after clamping the venous blood samples were taken for the hemoglobin and hematocrit levels. Mean and standard deviation were calculated for gestational age, birth weight, hemoglobin and hematocrit. Frequency and proportions were calculated for gender and polycythemia. Results: Mean gestational age of the mothers was 39.27 ± 1.50 weeks. Of 190 neonates, 91 (47.9%) were males, 99 (52.1%) were females. Mean birth weight was 3.64 ± 0.72 kg while mean Hb and HCT levels were 16.07 ± 2.30 g/dl and 63.26 ± 5.32% respectively. Keeping cut off value of 13.5 g/dl of Hb to label anemia or no, 35 (18.4%) neonates were anemic in this study. The polycythemia (HCT >65%) was present in 72 (37.9%) of neonates. There was no difference between groups in terms of gender, anemia, gestational age and birth weight (p values 0.663, 0.852, 0.700 and 0.491 respectively). The distribution of polycythemia was different among groups (p value 0.007). The mean hemoglobin level in group A was 15.52 ± 1.90 g/dl while in group B it was 16.62 ± 2.53 g/dl (p value 0.001). Mean Hb levels were statistically not different among some of the groups (gestational age <40 weeks, birth weight <4 kg) while HCT levels are significantly different among male group and category of birth weight >4 kg. Rest of the stratification groups showed significant difference. Conclusion: The delayed cord clamping in neonates results in increased mean hemoglobin and hematocrit levels with increased frequency of polycythemia as compared to early cord clamping.

scholarly journals Efficacy of lidocaine-prilocaine combination cream in reducing pain caused by hepatitis B injection in neonates: a randomized control trial

2007 ◽  
Vol 47 (1) ◽  
pp. 12
Author(s):  
Nugroho Karyadiguna ◽  
Soetjiningsih Soetjiningsih ◽  
W. Retayasa ◽  
M. Kardana
Keyword(s):  
Birth Weight ◽  
Hepatitis B ◽  
Gestational Age ◽  
Controlled Trial ◽  
Chronological Age ◽  
Medical Procedures ◽  
Double Blind ◽  
Term Neonates ◽  
The Mean ◽  
Lidocaine Prilocaine

Background Many invasive medical procedures cause pain inneonates. Pain in this age group increases morbidity, impairsemotional bonding, and causes hyperalgesia. Combination oflidocaine and prilocaine cream is one of the topical analgesicsthat are easy to use and safe for neonates.Objective To assess the efficacy of lidocaine-prilocainecombination cream in reducing pain caused by intramuscularinjection of hepatitis B and to find out the correlation of sex,gestational age, birth weight, chronological age, and method ofdelivery with infant’s pain response.Methods A double blind randomized controlled trial wasconducted on term neonates. Subjects were selected consecutivelyand every subject was randomized to either receive lidocaine-prilocaine cream or placebo one hour prior to administration ofintramuscular hepatitis B vaccine. The administration wasrecorded by a handycam and the intensity of pain responses wasevaluated using DAN (Douleur Aigue Nouveau-ne) scale.Results Of 67 subjects, the mean of DAN scale was 7.60 (95%CI 7.27;7.95) in the lidocaine-prilocaine cream group and thiswas significantly lower (P<0.0001) than in placebo group, whichwas 8.82 (95% CI 8.56;9.09). ANCOVA showed that there wereno associations between sex, gestational age, birth weight,chronological age, and method of delivery with infant’s painresponse.Conclusion Lidocaine-prilocaine combination cream can reducethe pain caused by intramuscular injection of hepatitis B vaccineon term neonates.

Might Bilirubin Serve as a Natural Antioxidant in Response to Neonatal Encephalopathy?

2018 ◽  
Vol 35 (11) ◽  
pp. 1107-1112 ◽  
Author(s):  
Alona Bin-Nun ◽  
Francis Mimouni ◽  
Yair Kasirer ◽  
Irina Schors ◽  
Michael Schimmel ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Hepatic Injury ◽  
Serum Bilirubin ◽  
Area Under The Curve ◽  
Total Serum ◽  
Control Group ◽  
Neonatal Encephalopathy ◽  
Term Neonates ◽  
Serial Serum ◽  
The Mean

Background Neonatal asphyxia is often associated with hepatic injury. We hypothesized that this might lead to increased bilirubin concentrations. Study Design Term neonates admitted between January 2015 and April 2017 who remained hospitalized for ≥ 4 days and who had serial serum bilirubin concentrations recorded were divided into those with neonatal encephalopathy (NE) and controls. Serial serum bilirubin concentrations during the first days of life were compared between groups. Results Twenty-nine neonates with NE and 84 age-matched controls were identified. Mean total serum bilirubin concentrations of NE babies were significantly lower than those controls throughout the first days of life. At 96 hours of age, NE serum bilirubin concentrations were 4.5 (3.2, 5.8) versus controls of 10.5 (9.4, 11.5) mg/dL (p < 0.0001). The mean area under the curve (AUC) for the NE group was 268 (215, 321) versus 663 (608, 718), p < 0.0001, for the control group. All of the NE babies remained below the 40th percentile of the Bhutani curve and none required phototherapy. Conclusion Contrary to our hypothesis, bilirubin concentrations in NE infants are significantly lower than expected during the first 4 days postnatally. We speculate that, under conditions of severe oxidative stress, bilirubin is consumed as an antioxidant.

scholarly journals Kramer Score, an Evidence of Its Use in Accordance with Indonesian Hyperbilirubinemia Published Guideline

2021 ◽  
Vol 18 (11) ◽  
pp. 6173
Author(s):  
Mahendra Tri Arif Sampurna ◽  
Muhammad Pradhika Mapindra ◽  
Muhammad Pradhiki Mahindra ◽  
Kinanti Ayu Ratnasari ◽  
Siti Annisa Dewi Rani ◽  
...  
Keyword(s):  
Birth Weight ◽  
Clinical Evaluation ◽  
Gestational Age ◽  
Serum Bilirubin ◽  
Newborn Infants ◽  
Clinical Score ◽  
Total Serum ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries

Background: In some hospitals in low/middle-income countries, methods to determine the bilirubin level in newborn infants are unavailable and based on a clinical evaluation, namely a clinical score designed by Kramer. In this study, we evaluated if this score can be used to identify those infants that need phototherapy. Method: Infants admitted between November 2018 and June 2019 to three hospitals in Surabaya, Indonesia were included. The jaundice intensity was scored using the Kramer score. Blood was sampled for total serum bilirubin (TSB) measurement. The infants were categorized into Treatment Needed (TN) group when treatment with phototherapy was indicated and the No Treatment Needed (NTN) group when phototherapy was not indicated, based on the Indonesian Guideline for hyperbilirubinemia. Result: A total of 280 infants with a mean birth weight of 2744.6 ± 685.8 g and a gestational age of 37.3 ± 2.3 weeks were included. Twenty-seven of 113 (24%) infants with Kramer score 2 needed phototherapy, compared with 41 of 90 (46%) infants with score 3 and 20 of 28 (71%) of infants with score 4. The percentage of infants that needed phototherapy was higher with decreasing gestational age. Conclusion: The Kramer score is an invalid method to distinguish between those infants needing phototherapy and those infants where this treatment is not indicated.

scholarly journals Comparison of light emitting diode and compact fluorescent lamp phototherapy in treatment of neonatal hyperbilirubinemia

2017 ◽  
Vol 4 (2) ◽  
pp. 341 ◽  
Author(s):  
Maharoof M.K. ◽  
Shamshad Ahmed Khan ◽  
Prakash Robert Saldanha ◽  
Reshad Mohamed
Keyword(s):  
Gestational Age ◽  
Serum Bilirubin ◽  
Light Emitting Diode ◽  
Neonatal Hyperbilirubinemia ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Fluorescent Lamp ◽  
Light Emitting ◽  
The Mean ◽  
Compact Fluorescent Lamp

Background: High levels of total serum bilirubin can cause life threatening complications in neonates requiring management either with phototherapy or exchange blood transfusion. Most commonly used modality of phototherapy is with blue light. There are many bulbs like fluorescent tubes, halogen spotlights etc. Due to disadvantages of the available bulbs, newer method like light-emitting diodes (LEDs) has been investigated as possible alternatives as they produce low heat, has a longer life span with lower energy consumption and rapid reduction of serum bilirubin level. The aim was to compare the efficacy between phototherapy equipped with light emitting diode (LED) to compact fluorescent lamp (CFL) in the treatment of neonatal hyperbilirubinemia among neonates.Methods: A hospital-based intervention study was conducted among 50 neonates born in the hospital during the study period, with gestational age more than equal to 35 weeks, being breastfed and healthy in a private medical college teaching hospital in Dakshina Kannada district from August to September 2016.  Following ethical committee clearance the neonates looking icteric by clinical examination were randomly allocated to receive CFL or LED phototherapy. Baseline, 24 hour total serum bilirubin and rectal temperature was measured.  Results: A total of 50 neonates were randomly allocated into two groups with almost similar characteristics between the two groups with respect to gender, type of delivery and gestational age. The mean bilirubin values (in mg/dl) among neonates in the CFL group and LED group were 14.8 and 15.6 respectively and post 24 hour values were 11.54 and 10.68 respectively. The mean difference in the reduction in the bilirubin values before and after receiving phototherapy between the two groups were significant (p <0.001). The increase in temperature was lesser among LED treatment group.Conclusions: LED therapy is better than the CFL therapy in terms of mean reduction in the total serum bilirubin after a fixed duration of time and lesser raise in temperature among the neonates.  

scholarly journals A study on effect of phototherapy on platelet count in neonates with unconjugated hyperbilirubinemia: a hospital based prospective observational study

2021 ◽  
Vol 12 (5) ◽  
pp. 41-46
Author(s):  
Santi Kumar Sarkar ◽  
Biswajit Biswas ◽  
Sumanta Laha ◽  
Nirban Sarkar ◽  
Monojit Mondal ◽  
...  
Keyword(s):  
Platelet Count ◽  
Observational Study ◽  
Gestational Age ◽  
Serum Bilirubin ◽  
Statistical Tests ◽  
Positive Association ◽  
Total Serum ◽  
P Value ◽  
Severe Thrombocytopenia ◽  
Unconjugated Hyperbilirubinemia

Background: Thrombocytopenia as a side effect of phototherapy has not been mentioned in standard literature and textbooks. Though there are few studies in this regard, but results are conflicting. Aims and Objective: Hence, the present study is undertaken to find out whether any significant change in platelet count occurs following phototherapy, and if there be any, to see whether the changes are transient or not. Materials and Methods: This prospective and observational study was carried out over a period of one and half years (1st March 2019 to 31st August 2020) on 190 new-borns admitted with idiopathic unconjugated hyperbilirubinemia needing phototherapy through consecutive enrolment. Serum bilirubin (total, conjugated and unconjugated) and platelet count were done before initiation and just after completion of phototherapy, and seven days after completion of phototherapy. Appropriate statistical tests were used to make statistical comparisons with a p-value of < 0.05 taken as significant. Results: Among 190 neonates, 108(56.8%) were male and 82(43.2%) were female; 90(47.4%) were preterm and 100(52.6%) were term. Mean birth weight was (2.4725 ± 0.4782) kg. Mean gestational age was (36.4316 ± 2.4802) weeks. Mean haemoglobin level was (17.3816± 1.0784) gm/dl. Mean age at presentation was (4.5737± 1.5811) days. Mean total serum bilirubin (TSB) before initiation, after completion, and 7 days after completion of phototherapy were (17.8595 ± 3.7034) mg/dl, (8.1726 ± 2.2586) mg/dl and (5.7279± 1.5918) mg/dl respectively. The mean duration of phototherapy required was (48.1895 ± 13.6054) hours. Mean platelet count before initiation and just after completion of phototherapy were (2,49,321.0526± 89,460.2101)/μL and (2,22,436.8421 ± 88,538.7173)/μL respectively. Mean platelet count 7days after completion of phototherapy was (2,46,210.5263 ± 87,442.3038)/μL. Decrease in platelet count just after completion of phototherapy was statistically significant. Fifty-nine (31.1%) out of 190 neonates developed mild thrombocytopenia (100000- <150000/μL) just after completion of phototherapy, but none developed moderate or severe thrombocytopenia. None having thrombocytopenia manifested with clinical bleed. Platelet count raised near to pre-phototherapy level 7 days after completion of phototherapy. Fall in platelet count was found to have a positive association with increased duration of phototherapy and lower gestational age (p<0.0001). However, there was no statistically significant association (p>0.05) between reduction in platelet count with gender. Conclusions: Though the incidence of thrombocytopenia following phototherapy was significant, but it was mostly mild and transient, and clinically insignificant. There was significant association between decrease of platelet count with duration of phototherapy and lower gestational age.

scholarly journals The forehead is a better site than the sternum to check transcutaneous bilirubin during phototherapy in sick infants

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jaesung Jeon ◽  
Gina Lim ◽  
Ki Won Oh ◽  
Na Mi Lee ◽  
Hye Won Park ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Neonatal Intensive Care Unit ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Serum Bilirubin ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Transcutaneous Bilirubin

Abstract Background To confirm the accuracy of transcutaneous bilirubin (TcB) in the neonatal intensive care unit both with and without phototherapy, and compare forehead and sternum as the TcB assessment site. Methods We simultaneously assessed the total serum bilirubin (TSB) and TcB at the forehead and sternum, using a JM-103 bilirubinometer. We analyzed the correlation between the TSB and TcB assessed at the forehead and sternum, with measurements classified as ‘without phototherapy’ (before phototherapy and > 24 hours after phototherapy discontinuation) and ‘with phototherapy’ (after 24 hours of phototherapy). Results There were 1,084 paired forehead and sternum TcB measurements, with the corresponding TSB measurement, from 384 infants. Their mean gestational age of 35.4 ± 3.2 weeks (62% were preterm) and a mean birth weight of 2434 ± 768 grams, and TSB was 6.61 ± 3.56 mg/dL. Without phototherapy, TcB values at the forehead and sternum were correlated well to the TSB value (r = 0.925 and 0.915, respectively). With phototherapy, TcB values at the forehead and sternum were significantly correlated with the TSB value, but TcB at the forehead (r = 0.751) was a better match to the TSB than was TcB at the sternum (r = 0.668). Additionally, Bland-Altman plots showed a greater degree of underestimation of the TSB by TcB at the sternum with phototherapy. Conclusions TcB was more accurate in infants not receiving phototherapy. During phototherapy, it is better to assess TcB at the forehead rather than at the sternum.

Vitamin D in Term Newborns: Relation with Maternal Concentrations and Birth Weight

2019 ◽  
Vol 75 (1) ◽  
pp. 39-46
Author(s):  
Carmem U.P. Esmeraldo ◽  
Maria Eliana P. Martins ◽  
Evanira R. Maia ◽  
Jéssica Lissandra A. Leite ◽  
José Lucas S. Ramos ◽  
...  
Keyword(s):  
Vitamin D ◽  
Birth Weight ◽  
Gestational Age ◽  
Serum Levels ◽  
Large For Gestational Age ◽  
Strong Positive Correlation ◽  
Term Infants ◽  
Cross Sectional ◽  
Term Newborns ◽  
The Mean

Objective: To evaluate vitamin D serum levels of term newborns and relate them to maternal concentrations and birth weight. Methods: Cross-sectional study carried out with 225 mothers and their term newborns. Data collected were maternal health, prenatal care, gestational, and anthropometric data of the newborns. The following laboratory tests were performed: serum levels of 25(OH)D, calcium, phosphorus, magnesium, and alkaline phosphatase. Results: Of the 225 newborns included in the study, 119 (52.9%) were males, the mean birth weight was 3,198 ± 421.4 g, and the gestational age was 39.1 ± 1.1 weeks. Of these, 20 (8.9%) were small and 12 (5.3%) were large for gestational age. A 25(OH)D sufficiency was found in 25.8% of mothers and 92% of newborns. The mean 25(OH)D concentrations of newborns was higher than that of the mothers 48.7 ± 15.2 ng/mL vs. 26.0 ± 6.7 ng/dL (p < 0.001), correlating inversely with birth weight (r = –0.249; p < 0.001). Small for gestational age (SGA) newborns had higher concentrations of 25(OH)D compared to adequate and large for age (p < 0.001). Conclusion: In conclusion, this study showed strong positive correlation between maternal and neonatal 25(OH)D concentrations, with higher values in newborns. The highest 25(OH)D concentrations were found in SGA term infants. We speculated these findings could be influenced by newborn body composition.

Effect of fluid supplementation with phototherapy in reducing the serum bilirubin levels in severe hyperbilirubinemia

2020 ◽  
Vol 11 (3) ◽  
pp. 3279-3283
Author(s):  
Anand Patil ◽  
Pawar J M ◽  
Kshirsagar V Y
Keyword(s):  
Weight Loss ◽  
Birth Weight ◽  
Incidence Rate ◽  
Gestational Age ◽  
Serum Bilirubin ◽  
Percentage Weight Loss ◽  
Fluid Supplementation ◽  
Percentage Weight ◽  
The Mean ◽  
Severe Hyperbilirubinemia

Hyperbilirubinemia otherwise called ”jaundice” is yellowish-green pigmentation of the sclera and skin brought about by an expansion in bilirubin creation or an imperfection in bilirubin elimination. Prospective randomized comparative correlational study carried out on babies admitted to NICU in Krishna Hospital. All healthy term babies (= 37 weeks) with non haemolytic hyperbilirubinemia with absolute serum bilirubin =20 mg/dl - = 25 mg/dl from second day of life to fourteenth day of life. Out of 811 babies admitted in NICU during the study period, 52 babies were admitted for severe hyperbilirubinemia in NICU. Thus, the incidence rate was 6.4%.out of these 28 (53.84%) were male and 24 (46.15%) were female. The frequency of extreme hyperbilirubinemia was more in inborn babies (78.88%) than out born babies (21.15%). The frequency of extreme hyperbilirubinemia with respect to birth weight were, Weights between 2000 gms-3000gms were 40 (76.9%) and weight above 3000 gms were 12 (23.07%). The percentage weight loss from the time of birth till admission between enhanced and non enhanced gatherings was comparable. In the study, 28 (53.84%) were delivered per vaginally, 24 (46.15%) were born by LSCS. Most neonates in our study, 31 (59.61%) cases presented with in 2-5 days, 20 cases presented between 6-10 days and only one case between 11-14 days. The mean gestational age of presentation in both groups was not significant. By unpaired T test both supplemental and non supplemental groups are comparable i.e., the levels of bilirubin, rate of reduction of bilirubin between 2 groups is not significant. By ANOVA test i.e., the levels of bilirubin, rate of reduction of bilirubin in both the groups is highly significant. The complete length of phototherapy required between2 groups is not significant. This information show that organization of extra intravenous liquid in embittered sound, term, breastfed neonates have no useful impact on the pace of serum bilirubin decrease during phototherapy.

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