Incidence Of Neonatal Hyperbilirubinemia Research Articles

Comparison of Three Methods of Umbilical Cord Management in Late Preterm and Term Newborns on Hemoglobin and Ferritin Levels at Six Weeks of Age: A Randomized Controlled Trial.

Umbilical cord milking (UCM) and delayed cord clamping (DCC) are strategies that improve the hemodynamic condition of the newborn and also increase the storage of iron. This study aimed to compare the effects of DCC with or without milking in late preterm and term neonates at different time intervals after birth (60, 120, and 180 seconds) on hematological and hemodynamic parameters in neonates at six weeks of age. In this double-arm, parallel-group, triple-blind, and active-controlled trial, all 150 eligible neonates were randomized with allocation concealment into three groups: Group A (DCC with UCM at 60 seconds), Group B (DCC with UCM at 120 seconds), and Group C (only DCC for 180 seconds). Hemodynamic parameters were recorded and compared during the first 48 hours, and hematological parameters were compared at six weeks of age. At six weeks, a significant difference in hemoglobin levels was noted between Groups A, B, and C (p<0.001). The difference in serum ferritin values at six weeks was also statistically significant in comparisons across all three groups (p=0.003). Regarding secondary outcomes examined, hemodynamic parameters and the incidence of neonatal hyperbilirubinemia were found to be comparable at 48 hours after birth. DCC followed by UCM at 120 seconds and DCC till 180 seconds proves superior to DCC with UCM at 60 seconds in preserving elevated hemoglobin levels and iron stores in neonates at six weeks of age. DCC for 180 seconds yielded comparable results, followed by UCM at 120 seconds. All three methods are considered safe and effective without compromising the neonate's hemodynamics.

Correlation Between APGAR Scores and the Incidence of Hyperbilirubinemia in Neonates at Wangaya Regional General Hospital, Denpasar

Background: Hyperbilirubinemia is defined as total serum bilirubin level at ≥ 5 mg/dl. In Indonesia, the prevalence of jaundice is 13,7-85%. One of the risk factors for hyperbilirubinemia in neonates is babies born with a history of asphyxia. The diagnosis of asphyxia can be enforced by the APGAR scoring system. This study aims to determine the relationship between APGAR values and the incidence of hyperbilirubinemia in neonates treated at Wangaya Regional General Hospital.&#x0D; Methods: This research is an analytic observational study using a cross-sectional approach, which was carried out in April-May 2022. The sample was taken by consecutive sampling. Bivariate analysis was performed using the chi-square test. Confounding variables will be controlled by design and by analysis. Influential risk factors were analyzed multivariate with logistic regression. Data were analyzed with SPSS software.&#x0D; Results: From 84 samples, 67, 9% had hyperbilirubinemia. The 1-minute APGAR score (P = 0,017, OR = 8,373, 95% CI; 1,468 – 47,738) and the 5-minute APGAR score (P = 0,034, OR =8,680, 95% CI; 1,172 – 64, 293) had significant correlation with the incidence of hyperbilirubinemia in neonates treated at Wangaya Regional General Hospital.&#x0D; Conclusion: Low APGAR scores have a significant correlation with the incidence of hyperbilirubinemia in neonates treated at Wangaya Regional General Hospital. The factor that most influences the incidence of hyperbilirubinemia is the 1-minute APGAR score. Neonates born with a low 1-minute APGAR score are 8,3 times at risk of experiencing hyperbilirubinemia.

Relationship between the Incidence of Neonatal Hyperbilirubinemia and Gestatinal Age as a Risk Factor

Neonatal hyperbilirubinemia (NH) or neonatal jaundice is characterized by elevated serum levels of total bilirubin in the blood and yellow color of the baby's skin, sclera, and mucous membranes. Neonatal hyperbilirubinemia can cause mild-moderate-severe neurological disorders, up to death, if left untreated. The incidence of neonatal hyperbilirubinemia (NH) in Indonesia in 2016 reached 51.47% of cases where 33.3% of the total NH cases were related to prematurity. The purpose of this study is to determine the incidence of NH in RSAB Harapan Kita This research is a type of quantitative analytical research with a cross sectional approach. The study population is babies born at RSAB Harapan Kita for the period January 2022 – December 2022. Using a random sampling technique with the slovin formula and a margin of error of 5%, a sample of 315 patients met the inclusion and exclusion criteria. Furthermore, statistical analysis was carried out using the chi-square test. As many as 158 (50.2%) babies born at RSAB Harapan Kita experienced NH with the most results of female babies (54.4%), aged 24-48 hours (48.1%), low birth weight (57%), and premature gestational age (67.7%). Bivariate analysis of the association of gestational age with NH incidence has a significance value of &lt;0.001 which proves a significant association. Conclusions: There is a significant association between preterm gestational age and NH incidence

A Significant Increase in the Incidence of Neonatal Hyperbilirubinemia and Phototherapy Treatment Due to a Routine Change in Laboratory Equipment.

Total serum bilirubin (TSB) analysis is pivotal for diagnosing neonatal hyperbilirubinemia. Because of a routine change in laboratory equipment, our TSB assay changed from a diazo to a vanadate oxidase method. Upon implementation, TSB results were substantially higher in newborns than expected based on the validation. To investigate the application of TSB and intermethod differences in neonates and their impact on phototherapy treatment. The diazo and vanadate methods were compared directly using neonatal and adult samples. Anonymized external quality control data were analyzed to explore interlaboratory differences among 8 commercial TSB assays. Clinical patient data were extracted from the medical records to investigate the number of newborns receiving phototherapy. The mean bias of the vanadate versus the diazo TSB method was +17.4% and +3.7% in neonatal and adult samples, respectively. External quality control data showed that the bias of commercial TSB methods compared with the reference method varied from -3.6% to +20.2%. Within-method variation ranged from 5.2% to 16.0%. After implementation of the vanadate TSB method, the number of neonates treated with phototherapy increased approximately threefold. Currently available TSB assays lack harmonization for the diagnosis of neonatal hyperbilirubinemia. Between-methods differences are substantially higher in neonatal compared with adult samples, highlighting the importance of including neonatal samples during assay validation. Close collaboration between laboratory specialists and clinicians is essential to prevent overtreatment or undertreatment upon the implementation of novel analyzers or assays. Also, harmonization of TSB assays, with an emphasis on neonatal application, is warranted.

Meta-analysis of the impact of pharmaceutical care on the outcome of gestational diabetes

ObjectivePharmaceutical care is based on pharmacy, effective organization, and the management of drugs and patients throughout the medication process, to promote the scientific and rational use of drugs. This study evaluated the clinical application value of pharmaceutical care in gestational diabetes mellitus through meta-analysis. MethodsUsing “gestational diabetes mellitus + pharmacist/pharmaceutical care/pharmaceutical service” as the search term, the CNKI, Wanfang, VIP, PubMed, and Wed of Science databases were searched from the establishment of the database to September 1, 2022. Quality assessment and meta-analysis were performed on the randomized controlled trial (RCTs) that met the inclusion conditions. ResultsA total of 1 092 patients were included from nine studies. The results showed that pharmaceutical care could improve the incidence of adverse drug events, medication compliance, medication deviation, satisfaction rate of blood glucose control, pregnancy-induced hypertension, polyhydramnios, premature membrane rupture, macrosomia, premature delivery, neonatal hypoglycemia, and neonatal asphyxia [(P<0.000 1)][relative risk degree (RR)=0.63, P<0.000 1], 95% confidence interval (CI) (0.52–0.76); RR=1.18, 95%CI (1.11–1.26); RR=0.65, 95%CI (0.56,0–76); RR=1.20, 95%CI (1.11–1.29); RR=0.28, 95%CI (0.17–0.44); RR=0.29, 95%CI (0.18–0.45); RR=0.24, 95%CI (0.13–0.46); RR=0.32, 95%CI (0.20–0.52); RR=0.35, 95%CI (0.24–0.52); RR=0.38, 95%CI (0.25–0.58); RR=0.36, 95%CI (0.23–0.56); RR=0.29, 95%CI (0.17–0.49), respectively]. In the pharmaceutical care group, the rate of mastery of self-management skills, the incidence of neonatal hyperbilirubinemia, and the incidence of fetal distress were all better than those in the traditional medical care group, the difference was statistically significant (0.000 01<P<=0.05) [RR=1.35, 95%CI (1.11–1.64), P<0.003; RR=0.46, 95%CI (0.22–0.93), P<0.05; RR=0.24, 95%CI (0.13–0.46), P<0.000 1]. After excluding the articles with high heterogeneity, the analysis showed that gestational diabetes women in the pharmaceutical care group had higher rates of self-management skills, cesarean section, and neonatal hyperbilirubinemia than those in the traditional medical care group; these differences were statistically significant (P<0.000 01) [RR=1.45, 95%CI (1.27–1.67); RR=0.73, 95%CI (0.64–0.84); RR=0.32, 95%CI (0.18–0.58)]. ConclusionPharmaceutical care can improve the maternal and fetal outcomes of gestational diabetes mellitus.

HUBUNGAN PEMBERIAN ASI DENGAN KEJADIAN HIPERBILIRUBINEMIA PADA NEONATUS DI RUANG PERINATOLOGI RS Tk.II UDAYANA

Jaundice is one of the most common clinical phenomena found in newborns, which can occur physiologically or pathologically. The high incidence of hyperbilirubinemia in the Perinatology Room of Rs Tk.II Udayana caused by the lack of breastfeeding in neonates can cause the baby to fall into a deteriorating condition and even neonatal death can occur. The purpose of this study was to determine the relationship between breastfeeding and the incidence of hyperbilirubinemia in neonates in the Perinatology Room of Rs Tk.II Udayana. This research is a quantitative research using correlational method with cross sectional approach. Sampling used a non-probability sampling technique, namely accidental sampling as many as 26 people. The research data were analyzed using chi square. Univariate test results showed that most of the respondents were breastfed as many as 16 people (61.5%) and most of the respondents experienced hyperbilirubinemia as many as 14 people (53.8%). The results of the bivariate test of this study were tested with the chi square statistical test, the -value was obtained. = 0.001 &lt;alpha (0.05) it can be concluded that there is a relationship between breastfeeding and the incidence of hyperbilirubinemia in neonates in the Perinatology Room of Rs Tk.II Udayana. This research is expected to be useful to add insight into the importance of breastfeeding for newborns.

Relationship Of Gestational Age With Hyper Bilirubin Incidence In 3 Days Neonates At Dustira Cimahi Hospital

One of the most typical clinical manifestations of the infant is hyperbilirubinemia. Jaundice sends more than 85% of term newborns back to the hospital within the first week of life. 60% of term newborns and 80% of preterm (less term) infants have hyperbilirubinemia. If hyper bilirubin is not appropriately treated, it can damage brain cells, cause seizures, and progress to kernicterus, even causing death. Even if the newborn gets kernicterus and recovers and can be passed, the baby can grow but not develop optimally and can even cause long-term effects such as mental impairment. This type of research is analytical research. This study was an observational study that related two variables: namely, the relationship between gestational age and the incidence of hyperbilirubinemia in neonates aged three days. The type of approach in this research is cross-sectional. Sampling was done using a purposive sampling technique with as many as 286 samples. The median gestational age for neonates with hyperbilirubinemia at Dustira Cimahi Hospital in 2021 was 36 weeks, still considered preterm, with a minimum gestational age of 30 weeks and a maximum of 43 weeks. The median bilirubin level in neonates with hyperbilirubinemia at Dustira Cimahi Hospital in 2021 was 10 mg/dL which was still classified as physiological hyper bilirubin, with a minimum level of 5.52 mg/dL and a maximum level of 16.03 mg/dL. There was a significant relationship between gestational age and the incidence of hyperbilirubinemia in neonates aged 3 days at Dustira Cimahi Hospital in 2021 with moderate strength and negative correlation direction.

Factors associated with the incidence of neonatal hyperbilirubinemia in Perinatology Ward of Wangaya General Hospital, Denpasar

Background: Hyperbilirubinemia is a condition defined by an increased total serum bilirubin level exceeding 5 mg/dL and clinically characterized by the presence of jaundice. Jaundice can be observed on the skin and sclera if the bilirubin level increases more than 5 mg/dL. Several risk factors, including birth weight, asphyxia, gestational age, mode of delivery, and breastfeeding practices, have been studied regarding their relationship to the incidence of hyperbilirubinemia, with varying results. Therefore, the purpose of this study was to determine the relationship between these risk factors and the incidence of hyperbilirubinemia.Methods: An analytical observational cross-sectional study was conducted by collecting secondary data from the Perinatology Ward registry and the medical records department. The subjects were neonates treated in the Perinatology Ward of Wangaya Hospital, Denpasar. The data that met the inclusion and exclusion criteria were then analyzed with the SPSS 25.Results: There were 59 neonates with hyperbilirubinemia and 135 neonates without hyperbilirubinemia among the 194 research subjects. The results of the chi-square test were the following: p-value for birth weight = 0.002, p-value for asphyxia = 0.002, p value for breastfeeding practice = 0.003, p value for gestational age = 0.000, and p value for delivery mode = 0.110.Conclusion: There was a significant relationship between birth weight, asphyxia, gestational age, breastfeeding practices, and the incidence of neonatal hyperbilirubinemia in the Perinatology Ward, Wangaya Hospital, Denpasar City. Meanwhile, no relationship was observed between the mode of delivery and newborn hyperbilirubinemia.

Comparison of hyperbilirubinemia incidence between the newborns of zinc-taking and non-zinc-taking mothers during the third trimester of pregnancy.

Background: Identification and control of the risk factors for hyperbilirubinemia can reduce the incidence and complications of this condition. Serum zinc level in newborns is reported to be one of the factors affecting the severity and incidence of neonatal hyperbilirubinemia. Therefore, the present study was conducted to compare hyperbilirubinemia incidence in neonates of zinc-taking and non-zinc-taking mothers.Methods:In this observational study, we compared the incidence of hyperbilirubinemia during the first week of birth between newborns whose mothers had received zinc supplement during the third trimester of pregnancy (case group) with those whose mothers had not taken zinc supplement (control group). The checklist of newborns’ conditions in both case and control groups was completed based on the obtained data regarding the infants, mothers, and laboratory findings. Data was analyzed using chi-squared test and t-test.Results:The mean serum levels of zinc were 79.76±15 mg/dl and 70.93±15.67mg/dl in mothers who had received zinc during the third trimester and those who had not taken zinc supplement, respectively. The mean serum level of zinc in newborns who underwent phototherapy was 41.68±9.21 mg/dl, while it was 68.53±20.85 mg/dl in neonates who did not receive phototherapy. In addition, 36% of the neonates whose mothers had not received zinc required phototherapy, while only 11% of newborns whose mothers had taken zinc supplement received phototherapy.Conclusion:Zinc consumption during the third trimester of pregnancy increased the serum zinc level in both newborns and mothers and reduced the incidence and severity of idiopathic hyperbilirubinemia requiring treatment.

A STUDY OF UMBILICAL CORD BILIRUBIN AS A PREDICTOR OF SIGNIFICANT NEONATAL JAUNDICE IN A TERTIARY RURAL CARE HOSPITAL

Introduction. Around 80 percent of preterm infants and 60 percent of term infants are affected by neonatal jaundice in the first week of life. Early discharge of healthy term infants is a common practice because of economic constraints and social reasons. Which new-borns are at increased risk for developing significant hyperbilirubinemia (Total serum bilirubin ≥ 15mg/dl) is difficult to predict. This study was taken up to evaluate the predictive value of cord blood bilirubin level for identifying term infants for subsequent hyperbilirubinemia. Material and methods. This prospective observational study was conducted in Adichunchanagiri Institute of Medical Sciences, Mandya, Karnataka from 1st of April 2020 to 30th September 2020. 100 healthy term babies satisfying the eligibility criteria and born in the study period were included in the study. Umbilical cord blood was collected and was correlated with serum bilirubin levels at 48hours of life. Significant hyperbilirubinemia was taken as ≥ 15mg/dl at 48 hrs of life. Results. The incidence of neonatal hyperbilirubinemia was 14%. By using umbilical cord blood bilirubin ≥ 3mg/dl, significant hyperbilirubinemia can be predicted with Sensitivity of 92.9%, Specificity of 96.5%, Positive Predictive Value of 81.3% and Negative Predictive Value of 98.8%. Conclusion. Umbilical cord blood bilirubin ≥ 3mg/dl in healthy term babies can help in prediction of significant jaundice and thus can help in identifying high risk new-borns so that these neonates can be followed up more closely, it can also help in identifying neonates who are not at increased risk of developing significant jaundice, hence can prevent unnecessary hospital stay.

Cord Blood Albumin as a Predictor of Neonatal Jaundice

Background: Neonatal jaundice is a very common condition worldwide occurring in up to 60% of term and 80% of preterm newborns in the first week of life. Even though extreme hyperbilirubinemia is rare in developed countries it is still quite rife in developing countries often resulting in kernicterus with its attendant medical, economic and social burden on the patient, family and society. Objective: The present study was conducted to evaluate the predictive value of umbilical cord blood albumin level for subsequent neonatal jaundice in healthy full-term neonates. Patients and Methods: The current study was carried out in the Pediatric Department, Faculty of Medicine, Aswan University Hospital. The study was conducted on 100 healthy full-term newborn after obtaining consent from parents. Cord blood was collected at birth and cord blood albumin estimation was done. Results: The incidence of neonatal hyperbilirubinemia in our study (64%). In terms of demographic data: males represented (32.5 %) of the jaundiced cases in the study and females represented (62.5 %); the difference was statistically insignificant (P value 0.325). Cord serum albumin level of (> 3.3) g/dl has a sensitivity of (86%) and specificity of (80%), PPV (81%), NPV of (85%) and the accuracy rate was (83 %) in predicting neonatal hyperbilirubinemia. Conclusion: There is significant correlation between cord serum albumin level and neonatal hyperbilirubinemia in healthy full-term neonates ≥ 2.5 kg birth weight and that serum albumin level taken from the blood of the umbilical cord is an effective way to predict neonatal hyperbilirubinemia in term healthy infants.

The characteristic of neonatal hyperbilirubinemia before and after phototherapy at Sanglah Hospital, Denpasar, Bali in 2017

Background: Hyperbilirubinemia is the most clinical problem in newborn babies. Hyperbilirubinemia occurs 60% in aterm babies and 80% in premature babies. This study aims to know the incidence of hyperbilirubinemia, characteristics of hyperbilirubinemia and effect of phototherapies to bilirubin levels.Methods: A cross-sectional retrospective study was conducted using medical records among 94 neonates with hyperbilirubinemia who treated with phototherapies at Sanglah hospital during 2017. Data regarding gender, gestational weeks, type of delivery, size for gestational age, the onset of hyperbilirubinemia, etiology, birth weight, maternal gravid status, and bilirubin levels were collected and analyzed using SPSS version 20 software descriptively.Results: From 94 neonatal hyperbilirubinemia that meet the inclusion criteria, 51 (54.3%)  males and 43 (45.7%) females based on gender. Mean gestational ages were 36.35±2.921 weeks. The major etiology of neonatal hyperbilirubinemia were breastfeeding jaundice 33 (25.8%), Prematurity 23 (18.7%), ABO incompatibility 13 (10.6%), Breast milk jaundice 11 (8.9%), gastrointestinal malformation 6 (4.9%), G6PD deficiency 5 (4.1%), and sepsis 3 (2.4%). The mean total bilirubin prior to phototherapy was 15.6±4.11 mg/dL whereas the indirect bilirubin was 14.56± 3.55 mg/dL. The duration of phototherapy in this study was 2.8±0.65 days.Conclusions: The incidence of neonatal hyperbilirubinemia during 2017 at Sanglah Hospital were predominantly caused by breastfeeding jaundice, prematurity, and ABO incompatibility. There were decreased bilirubin levels following phototherapies.

Incidence of Hyperbilirubinemia in Neonates of Parturients Undergoing Augmentation of Labor With Oxytocin: A Prospective Cohort Study

Incidence of Hyperbilirubinemia in Neonates of Parturients Undergoing Augmentation of Labor With Oxytocin: A Prospective Cohort Study

Decreased The Risk of Hyperbilirubinemia Incidence With The Initiation of Early Breastfeeding

Hyperbilirubinemia is a state where increase value of in serum bilirubin in the blood more &gt; 5mg/dl, which is clinically characterized by jaundice on sclera and skin, hyperbilirubinemia can be caused by physiological processes, non-physiological, or a combination of both. Neonates were given early initiation will result in the expenditure of meconium early so tend to have a low risk of the occurrence of physiological hyperbilirubinemia. Research will aim to detect early initiation on the incidence of neonates physiologic hyperbilirubinemia in neonates born at Khadijah room Islamic Hospital Muhammadiyah Kendal. Research kind quasi-experiment by using plant form post test only in a body (one group post test only design). Population in this research patient newborn at Khadijah room Islamic Hospital Muhammadiyah Kendal. Research sample as much as 30 respondens early initiation and 30 respondens not early initiation by using technique purposive sampling. Data analysis included univariate analysis by finding frequency distribution, bivariate analysis with Mann-Whitney Test. The research result of bivariate analysis shows that neonates with early initiation total serum bilirubin value performed intervention group averaged 8,200mg/dl while control group averaged 11,647mg /dl. The initiation of early breastfeeding (IMD) effect on total serum billirubin content of the neonatus. The variables that have contributed to the total serum billirubin content were the implementation of early breastfeeding initiation (IMD) with an effect of 61.2% and influenced by other variables of 38.8%. The conclusion there is influence of early initiation of suckling on physiological hyprbilirubinemia at Islamic Hospital Muhammadiyah Kendal.

Prognostic value of peripheral blood eosinophil count on first day of infancy in the incidence of neonatal hyperbilirubinemia

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Neonatal jaundice is one of the most common problems in the neonatal period. Eosinophilia is common in preterm and term newborns, and it is considered when the absolute count of eosinophil is ≥500 cell/mm&lt;sup&gt;3&lt;/sup&gt;. It is thought that there was some relationship between hyperbilirubinemia and increasing of blood eosinophil count in newborns hospitalized by jaundice. The aim of this study was to determine the prognostic value of peripheral blood eosinophil count on first day of infancy in the incidence of neonatal hyperbilirubinemia.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; 150 newborns with gestational ages of 35-40 weeks, born in Ardabil city hospital, were engaged in this study. After obtaining the parents' consent, getting patients biography and their physical examination, we got a blood sample from umbilical cord of newborns to measure differential count of white blood cells. The neonates were observed up to 28 day followed. Then, second blood test conducted for the purpose of measuring serum level of bilirubin. Data were analyzed by statistical methods in SPSS version 19. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Various group of age, sex, blood type and gestational age showed no significant difference in their eosinophil rate. Total serum bilirubin doesn't had a significant relationship with gestational age, sex, type of delivery and major or minor blood groups of neonates.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Results showed that there was no significant relationship between the amount of eosinophil in newborn umbilical cord and total serum bilirubin. So, we could say that newborns eosinophil count isn’t a good criteria for predicating the appearance of neonate hyperbilirubinemia.&lt;/p&gt;

Incidence of neonatal hyperbilirubinemia in low, intermediate-low, and intermediate-high risk group infants

Background Neonatal hyperbilirubinemia is commonly found in newborns. Assessment of the risk of hyperbilirubinemia and information on the average time of the occurrence of hyperbilirubinemia are important to prevent the development of severe hyperbilirubinemia.Objective To find out the incidence of and the time of the development of hyperbilirubinemia in healthy-term newborns.Method A cohort prospective study was done on healthy-term newborns born at Hasan Sadikin Hospital between November and December 2009. Subjects were divided into 4 groups of risk at discharged, based on Bhutani nonnogram. A serial bilirubin level measurement were perfonned within 6 days.Resu l ts One of 14 newborns at low risk group developed hyperbilirubinemia but did not need phototherapy. Six of 14 newborns at intermediate-low risk group developed hyperbilirubinemia, 2 of them needed phototherapy with total serum bilirubin level of 14.7 mg/dL at 57 hours and 19.8 mg/dL at111 hours. Nine of 15 newborns of intennediate-high risk group developed hyperbilirubinemia, 1 of them needed phototherapy with total serum bilirubin level of 16.6 mg/dL at 76 hours. There was no newborn cathegorized as high risk group in this study. The median time the occurrence of hyperbilirubinemia in intennediate-low and intennediate-high risk group was 140 hours and 82 hours, respectively. There was no significant difference in survival curve between intennediate-high and intennediate-low risk groups (95% CI 108.1 to 1 2 5.4).Conclusion The incidence of hyperbilirubinemia was not different between intennediate-low and intermediate-high risk babies.

Predicting Nonhemolytic Neonatal Hyperbilirubinemia.

Before hospital discharge, newborn infants should be assessed for the risk of excessive hyperbilirubinemia. We determined maternal and obstetric risk factors for hyperbilirubinemia in infants born at term (gestational age ≥37 weeks) to form an individualized risk assessment tool for clinical use. This was a population-based study with data from the Swedish Medical Birth Register from 1999 to 2012, including 1,261,948 singleton infants. Outcome was defined as infants diagnosed with hyperbilirubinemia (N = 23,711), excluding all cases of hemolytic (immune-mediated or other specified hemolytic) diseases of the newborn. Risk factors with an adjusted odds ratio (aOR) for neonatal hyperbilirubinemia of ≥1.5 (medium-sized effect or more) were gestational age 37 to 38 weeks (aOR = 2.83), failed vacuum extraction (aOR = 2.79), vacuum extraction (aOR = 2.22), Asian mother (aOR = 2.09), primipara (aOR = 2.06), large-for-gestational-age infant (aOR = 1.84), obese mother (aOR = 1.83), and small-for-gestational-age infant (aOR = 1.66). Planned cesarean delivery (CD) was associated with a reduced risk (aOR = 0.45). Without any of these risk factors (normal birth weight infant delivered vaginally at 39 to 41 weeks' gestation by a non-Asian, nonobese, multiparous mother) the rate of nonhemolytic neonatal hyperbilirubinemia was 0.7%. In relation to the combined load of different risk factors, rates of neonatal hyperbilirubinemia ranged from 0.2% to 25%. Collection of a few easily available maternal and obstetric risk factors predicts >100-fold variation in the incidence of neonatal hyperbilirubinemia. The information provided herein enables individualized risk prediction with interactions between different risk factors taken into account.

Pre-Discharge Screening Trans-Cutaneous Bilirubinometry in Healthy Newborns in Mahdieh Hospital, Tehran.

Background:Incidence of jaundice is high in newborn infants. Since well appearing newborns are rapidly and routinely discharged from hospital, performing an inexpensive noninvasive pre-discharge screening test for evaluation of jaundice seems to be necessary.Objectives:This study was conducted to compare the accuracy of cutaneous v/s serum bilirubin measurements in this regard.Patients and Methods:This was a prospective cross sectional study conducted in Mahdieh hospital, Tehran. 613 neonates weighing ≥ 1,800 g with gestational age of ≥ 35 weeks were enrolled. A pre discharge transcutaneous bilirubin test (TcB) was performed in all. Serum samples were taken from neonates with TcB ≥ 5 mg/dL in first and > 8 mg/dL in second 24 hours. Decision for treatment or recheck of bilirubin level after discharge was made based on serum bilirubin results.Results:Based on the study protocol, among 613 studied neonates, 491 (80%) revealed high TcB, of them 240 (49%) cases showed TBC ≥ 5 mg/dL in first and 251 (51 %) in second pre-discharge 24 hours. TcB ranged 3.3 - 17.1, mean TcB in first 24 hours was 6.9 ± 1 .7 (mode 6) and in second 24 hours 9.1 ± 2.1 (mode 10). Of 491 neonates with high TcB, capillary serum sample was taken as the second step and 398 neonates revealed high total serum bilirubin (TsB) with the same protocol for TcB. 108 (27.1%) neonates showed TsB ≥ 5 mg/dL in first and 290 (72.9%) in second 24 hours. According to the study results TcB has a 81% positive predictive value (PPV) in diagnosis of hyperbilirubinemia. Correlation coefficient of TcB and TsB in highest rate is equal to 72% (P value < 0.001).Conclusions:TcB is an inexpensive, noninvasive and precise pre-discharge screening test for evaluation of hyperbilirubinemia, with a high PPV. It is highly recommended to be performed routinely due to high incidence of hyperbilirubinemia in neonates.

Prediction of severe neonatal hyperbilirubinemia using cord blood hydrogen peroxide: a prospective study.

BackgroundWe hypothesized that cord blood hydrogen peroxide (H2O2) could be utilized to predict the severity of neonatal hyperbilirubinemia.MethodsWe prospectively enrolled term or near-term healthy neonates. Cord blood and capillary blood at three days of age were measured for hydrogen peroxide and bilirubin concentrations. For newborns with hyperbilirubinemia, further blood samples were obtained at five and seven days of age. Newborns were divided into severe or less severe hyperbilirubinemic groups (peak bilirubin ≥17 mg/dL or not). The sensitivity, specificity, and negative predictive values were determined.ResultsThere were 158 neonates enrolled. The incidence of neonatal hyperbilirubinemia was 30.5% for a concentration ≥15 mg/dl. The rising patterns were similar among bilirubin concentrations and hydrogen peroxide levels during the first few days of life. There was a strong positive correlation between bilirubin concentrations and hydrogen peroxide levels after correlation analysis. The rate of severe hyperbilirubinemia was 13.3%. It revealed that a cord blood hydrogen peroxide signal level of 2500 counts/10 seconds was an appropriate cut-off for predicting severe hyperbilirubinemia. Sensitivity and the negative predictive value were 76.2% and 93.3%, respectively.ConclusionsOur findings confirm that hydrogen peroxide levels and bilirubin concentrations in cord and neonatal blood are closely related. A cord blood hydrogen peroxide level above 2500 counts/10 seconds associated with a high predictive value for severe hyperbilirubinemia. This method provides information about which neonate should be closely followed after discharge from the nursery.

A study of neonatal hyperbilirubinemia in a tertiary care hospital

Background: Neonatal Hyperbilirubinemia is a common problem encountered in neonates and often requires admission and treatment. Aims & Objectives: To determine the incidence, etiology and risk factors associated with neonatal hyperbilirubinemia in a tertiary care hospital. Materials and Methods: A retrospective study was conducted on data obtained on live births for 2012 and 2013.All treated cases of neonatal hyperbilirubinemia were analyzed and data on gender, gestation age, mode of delivery, blood group incompatibility, sepsis, parity and birth weight were obtained. Results: 753 neonates were treated for hyperbilirubinemia, the total number of live births was 5589. The incidence of neonatal hyperbilirubinemia was 13.47%. ABO blood group incompatibility was the most common cause of hyperbilirubinemia. Conclusion: Blood Group incompatibilities, sepsis, and cephalohematoma were the common causes of hyperbilirubinemia, however in nearly a third of all cases etiology could not be determined. Preterm gestation and low birth weight were associated risk factors.