Prenatal and postnatal exposure to ambient air pollution and asthma in neonatal jaundice infants

Background: Both air pollutants and neonatal jaundice (NJ) have known effects on childhood asthma, but higher total serum bilirubin (TSB) level was associated with lung protection. This study aimed to assess whether prenatal/postnatal exposure to air ambient pollutants is related to the inception of asthma in NJ infants. Material and methods: A nested case-control retrospective study of NJ infants was performed on the Kaohsiung Medical University Hospital Research Database between 2009 and 2019. The average concentration of particulate matter (PM2.5), sulfur dioxide (SO2), nitric dioxide (NO2) for six months, first and second years after the birth, and first, second and third trimesters prenatally were analyzed. The mild and significant NJ infants were categorized as TSB level < and ≧12 mg/dl, respectively. Asthma was defined as a diagnosis with medication. The adjusted odds ratio (aOR) and 95% confidence interval (CI) present the relationship between study periods and childhood asthma. Results: SO2 and NO2 exposure during prenatal periods were significantly associated with increased risk of childhood asthma in mild NJ infants (aOR (95% CI)), SO2: 1.20-1.34 (1.05-1.56); NO2: 1.06-1.07 (1.01-1.13)). Effects were more pronounced in postnatal exposure to three ambient air pollutants in mild jaundice infants. (aOR (95% CI), SO2: 1.33-1.41 (1.14-1.69); NO2: 1.07-1.31 (1.01-1.49; PM2.5:1.05 (1.00-1.10) Conclusion: Both SO2 and NO2 during prenatal and postnatal exposure in mild NJ infants were associated with childhood asthma. Whether taken phototherapy or not, significant NJ infants were spared by three ambient air pollutants.

Disease Burden of Neonatal Care Unit at Al-Bayda Medical Center Al-Bayda Libya

This research was conducted to determine the number, disease pattern, and outcome of the patients admitted at the Neonatal Care Unit (NCU) at Al-Bayda medical center (AMC) in Libya. A retrospective cross-sectional descriptive study was carried out on all neonates admitted to the NCU between January 2008 and December 2008. The collected data include age, gender, mode and site of delivery, number of gestations, maturity, duration of stay, cause of admission, and outcome. Total infants delivered were 10075, 620 (6.1%) of them were admitted to NCU with a (6.15%) admission rate, 56.5% were male and 43.5% were female, of whom 613 (98.9%) were inborn and 519 (83.7%) were term neonates; 523 (84.4%) of total born were by normal vaginal delivery (NVD). 48.7% of total admissions occurred during the first 24 hours of life. The average length of hospital stay for term births was 5.6 days (SD 5.4) and for preterm 8.7 days (SD 8.55). The common causes of admission were neonatal jaundice (29.3%), followed by neonatal infections (17.6%) were prematurity accounts for (16.3%), and respiratory distress (11.1%). The majority of the admitted neonates improved and were discharged 517 (83.4%), 37(6%) left against medical advice (LAMA) and nineteen (3%) were referred to other specialized hospitals for further management. The neonatal mortality rate was 0.4%, and the overall hospital neonatal mortality rate was 7.6%. According to the cause-specific death rate analysis, prematurity was the most common cause of death (29.8%), followed by sepsis (17%) and birth asphyxia (12.8%). In conclusion, neonatal jaundice, infection, and prematurity complications were the leading causes of morbidity in neonates. The case-fatality rate was high for prematurity, sepsis, and birth asphyxia. Most of these etiologies are preventable to some extent by regular prenatal visits, healthy delivery practices, and timely referral to hospitals which can reduce NCU burden and improve outcomes

THE PREVALENCE AND RISK FACTORS FOR HYPERBILIRUBINEMIA IN NEONATES

Background: Jaundice is very common in the neonatal period of life especially hyperbilirubinemia>12 mg/dl. Although it is not a major cause of mortality, it is an important cause of morbidity. So, assessment of the prevalence and risk factors of neonatal jaundice is very important. Objectives: The objectives of the study were to estimate the prevalence,to identify the risk factors and to findout the association between hyperbilirubinemia with selected neonatal,maternal,environmental and socio demographic variablesand to identify the risk factors. Methodology: This descriptive cross sectional survey study was conducted among 200 neonates of 37 completed weeks of gestation. Subjects were selected by using total enumerative sampling.Transcutaneous bilirubin was measured by bilirubinometer,clinical and demographic variables collected by using semi structured questionnaire and the risk factors were assessed by interview schedule. Results:Research showed that most of neonates (81.5%) had Transcutaneous bilirubin level more than 12mg/dl, out of that (15% )subjects had elevated level of bilirubin 15- 20mg/dl. It is concluded that there is high prevalence of hyperbilirubinemia among neonates . It is evident that neonates developed hyperbilirubinemia by 48 to 72 hours. It is inferred that prevalence of hyperbilirubinemia was high at 72 hours (56.5%) after birth compared to 48 hours of birth (38%). There was a significant association between level of hyperbilirubinemia and family history of genetic diseases (P=0.003),parity (p=0.03, χ2=4.37),mode of conception(p=0.012, χ2=6.37), and gestational age(P=0.04),gender of the neonate (p=0.004, χ2=8.1)and duration of second stage of labour (p=0.026, χ2=7.27). The study revealed that the family history of genetic diseases (p=0.004),(OR=0.09) at level of significance 0.05,is a risk factor leads to hyperbilirubinemia. Conclusion: Neonatal jaundice is a leading cause of hospitalisation in the first few weeks of life throughout the world.Though major complications may arise like kernicterus,encephalopathy and neural sequlae.Hence there is an exigent need for assessing the bilirubin value in the routine neonatal assessment.

The Association of Hepatitis B Virus Replication During Pregnancy with Perinatal Outcomes: A Retrospective Cohort Study

Background The effect of hepatitis B virus (HBV) replication during pregnancy on the outcomes of singleton pregnancies is not fully understood. In this study, we investigated the association between HBV replication and poor maternal and infant outcomes. Methods We retrospectively analyzed the clinical data of 836 pregnant inpatients with hepatitis B surface antigen positivity who delivered at two provincial tertiary grade A hospitals in Fujian Province from June 2016 to October 2020. The patients were divided into the HBV replication (n = 283) and non-HBV replication groups (n = 553). Chi-squared test of adverse maternal and infant outcomes was performed using SPSS 26.0 software, and univariate analysis of variance of basic clinical indexes of pregnant women and newborns was performed. P<0.05 was considered statistically significant. Results The incidences of perinatal outcomes of intrahepatic cholestasis of pregnancy, hypertensive syndrome complicating pregnancy, gestational diabetes mellitus, preterm birth, macrosomia, growth restriction, and vaginal infection in the HBV and non-HBV replication groups were not significantly different (P>0.05); however, there were significant differences between the two groups in the rate of cesarean section (53.8% vs. 45.0%; P=0.017) and neonatal jaundice (15.5% vs. 7.2%; P=0.000). After using propensity score analysis and multivariable modeling to adjust for glutamic pyruvic transaminase and glutamic oxaloacetic transaminase levels in the two groups, the replication group was found to have an increased risk for cesarean section (54.3% vs. 33.5%; P=0.000) and vaginal infection (3% vs. 0.4%; P=0.038), and their infants had a higher rate of newborn jaundice (16% vs.1.5%; P=0.000). Conclusion The findings provide further understanding of the association between maternal HBV replication status and perinatal outcomes. Pregnant women with viral replication have an increased risk of vaginal infection and cesarean section, and their infants appear to be at a higher risk for neonatal jaundice.

Association of Neonatal Jaundice with Gut Dysbiosis Characterized by Decreased Bifidobacteriales

Neonatal jaundice, caused by excess serum bilirubin levels, is a common condition in neonates. Imbalance in the gut microbiota is believed to play a role in the development of neonatal jaundice. Thus, we aimed to reveal the gut microbiota characteristics in neonates with jaundice. 16S rRNA gene sequencing was performed on stool samples collected on day 4 from 26 neonates with jaundice (serum total bilirubin > 15.0 mg/dL) and 17 neonates without jaundice (total serum bilirubin < 10.0 mg/dL). All neonates were born full term, with normal weight, by vaginal delivery, and were breastfed. Neonates who were administered antibiotics, had serum direct bilirubin levels above 1 mg/dL, or had conditions possibly leading to hemolytic anemia were excluded. The median serum bilirubin was 16.0 mg/dL (interquartile range: 15.5–16.8) and 7.4 mg/dL (interquartile range: 6.8–8.3) for the jaundice and non-jaundice groups, respectively. There was no difference in the alpha diversity indices. Meanwhile, in the jaundice group, linear discriminant analysis effect size revealed that Bifidobacteriales were decreased at the order level, while Enterococcaceae were increased and Bifidobacteriaceae were decreased at the family level. Bifidobacteriaceae may act preventatively because of their suppressive effect on beta-glucuronidase, leading to accelerated deconjugation of conjugated bilirubin in the intestine. In summary, neonates with jaundice had dysbiosis characterized by a decreased abundance of Bifidobacteriales.

Effect of Systematic Holistic Nursing Combined with the MDT Teaching Method in the Nursing of Neonatal Jaundice and Its Impact on the Recovery of the Newborns’ Physiological Function

The application effect of systematic holistic nursing combined with the multidisciplinary team (MDT) in the nursing of neonatal jaundice was explored. This study was a retrospective control study. 90 cases of neonatal jaundice admitted to our hospital (February 2020–February 2021) were equally split into group P treated with routine nursing and group Q treated with systematic holistic nursing combined with MDT. The application effect of the two nursing programs was compared and analyzed. Groups P and Q showed no statistical difference in general data ( P > 0.05 ). Compared with group P, the jaundice regression time, hospitalization time, time of first defecation, and time of meconium turning yellow of group Q were notably shorter, and the body weight and total treatment efficiency of group Q were notably higher ( P < 0.05 ). From the third day, the daily jaundice indexes between the two groups were different; that is, the indexes of group Q were notably lower compared with group P ( P < 0.05 ). The scores of environmental nursing, special nursing, basic nursing, and service attitude in group Q were notably higher compared with group P ( P < 0.05 ). In the nursing process of neonatal jaundice, the combination of systematic holistic nursing and MDT can effectively shorten the time of first defecation and meconium turning yellow, reduce jaundice indexes, promote the recovery of the physiological function, and improve the clinical efficacy and nursing quality.

The Effects of Wet Cupping in the Management of Neonatal Jaundice: A Case Series Observation

The article's abstract is not available.

The Traditional Practices of Mothers in Caring of Neonates Affected by Hyperbilirubinemia

Objectives: The current study aimed to identify the mothers’ traditional practice in caring for newborns with jaundice; we want to determine the association between mothers’ practices and their demographic characteristics. Methods: This cross-sectional study was conducted on 100 mothers from inpatient pediatric wards of Babylon Teaching Hospital for maternal and pediatric care. They were selected by non-probability, purposive sampling method. The study data were collected by a three-part tool: demographic data sheet related to mothers and children, mothers’ knowledge concerning neonatal jaundice, and the mother’s knowledge and home practices concerning neonatal jaundice. The obtained data were analyzed using the SPSS version 22. Results: Most mothers (67%) were younger than 30 years, and 10% had college or institute educational level. Also, 87% of mothers knew that jaundice is a common problem for neonates; 25% did not know that jaundice is abnormal if it occurs within the first 36 hours. About 17% of mothers did not agree that maternal and fetal blood group differences lead to jaundice. Besides, 47% of mothers were uncertain that severe jaundice could lead to deafness, and 78% knew that phototherapy is the treatment for jaundice. Discussion: The majority of respondents in the study were aged 29 years or less. Most of them adopted breast and formula as the type of feeding. The most recognizable outcome of this study was the adequate knowledge and practices of mothers concerning traditional caring for neonates with jaundice.