Abstract
Introduction: Unconjugated bilirubin jaundice is a common symptom in neonatal period. In some babies, excessive serum bilirubin concentrations can place them at risk of acute bilirubin encephalopathy (BE) when the unconjugated pigment crosses the blood-brain barrier. Our study aimed to describe epidemiology, diagnosis and prognosis of BE at the Neonatology Department of Albert Royer Children’s Hospital of Dakar. Materials and Methods: It was a retrospective, descriptive study of cases of BE from January 1, 2015 to June 30, 2019. Obstetric and perinatal data as well as postnatal jaundice data (onset time, associated signs, signs of encephalopathy, treatment and evolution) were collected and analyzed by SPSS software version 2.0. Almost all newborns (27 cases; 90%) were exclusively breastfed. At admission, all children exhibited blunt jaundice and signs of encephalopathy dominated by the abolition of archaic reflexes (76.7%), low suction (22 cases; 73.3%), central apnea (12 cases, 40%). The mean serum bilirubinemia was 322 mg/litre. Neonatal infection (10 cases; 33.3%) and fetal-maternal incompatibility (16 cases; 53.3%) were the main causes. All children received intensive phototherapy and exsanguino transfusion was performed for 7 newborns (23.3%). Nine children died (30% mortality rate). Conclusion: Only better organisation of perinatal care with enhanced postnatal follow-up can reduce the incidence of EB.
Highlights
IntroductionUnconjugated bilirubin jaundice is the most common symptom in neonatal period, affecting up to 50% - 70% of newborns [1]
Unconjugated bilirubin jaundice is a common symptom in neonatal period
Excessive serum bilirubin concentrations can place them at risk of acute bilirubin encephalopathy (BE) when the unconjugated pigment crosses the blood-brain barrier
Summary
Unconjugated bilirubin jaundice is the most common symptom in neonatal period, affecting up to 50% - 70% of newborns [1]. The prevalence of BE is high in low resources countries, such sub-Saharan Africa, with a significant morbimortality [5] [6] [7]. The incidence of severe neonatal jaundice in the African region in 2017 was estimated at 667 cases/10,000 live births (LB) compared with only 3.7 cases/10,000 LB for the European region [8]. Buthani in 2010 estimated that of 75.400 annual cases of BE worldwide, 35% occurred in sub-Saharan Africa, corresponding to a prevalence of 56 cases per 100.000 LB, compared to 37% in South Asia.
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