Incidence Of Neonatal Jaundice Research Articles

EFFECTS OF UMBILICAL CORD MILKING ON HEMATOLOGICAL PARAMETERS IN TERM NEONATES: A CASE CONTROL STUDY IN A TERTIARY CARE HOSPITAL

Delayed cord clamping (DCC) and Umbilical cord milking (UCM) are the two methods of placental transfusion. Bothinterventions improve hemoglobin, are safe with no risk of polycythemia and hyperbilirubinemia. UCM is benefi cial in situation were DCC is not feasible or contraindicated.Objectives. 1) Comparison of UCM and DCC on following hematological parameters in term neonates- Cord Hemoglobinat birth, Hemoglobin, Hematocrit and Bilirubin at 48 hours of life. 2) To compare Hb and ferritin levels of infants born withUCM to that of DCC at 6 weeks of age.Material and methods. A Prospective Case- Control Study. Newborns delivered by normal vaginal and elective lower segmentcesarean section underwent DCC. Neonates in whom DCC was not feasible underwent UCM. 56 neonates in each group were followed up to 6 weeks. Cord hemoglobin at birth, hemoglobin, hematocrit and bilirubin were sent at 48 hours, and during 6 weeks of life, Hb and serum ferritin was estimated in both groups and compared.Results: At 48 hours, mean hemoglobin is 18.75 and 19.38 g/dL, mean hematocrit is 52.20 and 53.94 %, and mean totalbilirubin is 11.56 and 10.39 mg/dL in the DCC and UCM groups, respectively. Mean hemoglobin at 6 weeks is 11.37 and 11.6 gm/dL and mean serum ferritin is 207.2 and 252.63 mcg/L in the DCC and UCM groups, respectively. No increase in the incidence of neonatal jaundice or polycythemia was observed in either group.Conclusion. Both the methods of placental transfusions DCC and UCM are equally eff ective and have comparable benefi ton hematological parameters in full term neonates at 48 hours of life and at 6 weeks of life.

Hubungan Antara Frekuensi Pemberian ASI dengan Kejadian Ikterus Neonatorum Pada Bayi Usia 0-7 Hari di Puskesmas Wangkal

Neonatal jaundice is a clinical condition in infants characterized by yellow discoloration of the skin and sclera due to excessive accumulation of unconjugated bilirubin. Jaundice will clinically appear in newborns when the blood bilirubin level is 5-7 mg/dL. Breast milk contains nutrients, hormones, elements of immunity, growth, allergy, and anti-inflammation. Nutrition in breast milk includes nearly 200 elements of food substances. The purpose of this study was to find out whether there is a Correlation between the frequency of breastfeeding and the incidence of neonatal jaundice in infants aged 0-7 days at the Wangkal Health Center in 2023. The study design used correlation analysis with a cross-sectional approach. The data collection technique used was observation with 90 respondents using accidental sampling techniques. Data collection includes coding, editing and tabulating, then analyzed manually and by computer with the Chi-Square Test. Results of the study 90 respondents Most the frequency of breastfeeding was carried out frequently by 57 respondents (63.3%) and the incidence of neonatal jaundice in infants aged 0-7 days did not occur jaundice by 55 respondents (61%) obtained P Value: 0.000 and α : 0.05, meaning that H0 is rejected and H1 is accepted so that there is a Correlation between the frequency of breastfeeding and the incidence of neonatal jaundice in infants aged 0-7 days at the Wangkal Health Center in Probolinggo in 2023. It is hoped that knowledge about the frequency of breastfeeding with neonatal jaundice is important in infants aged 0-7 days at the Wangkal Health Center, Probolinggo in 2023. Where it can reduce the prevalence of infant jaundice and increase infant immunity.

FRI632 Metformin Use In Gdm Is Not Associated With Increased Incidence Of Preterm Labor And Small For Gestational Age Infants Compared To Diet Control Alone

Abstract Disclosure: A. D'Souza: None. F. Badri: None. H. Abdullahi: None. I. Ibrahim: None. Gestational diabetes mellitus (GDM), the most frequent medical complication of pregnancy, is becoming a growing public health issue with its national prevalence of 21.5% greater than the estimated global prevalence of 17%.1,2 Among those who required treatment for GDM in Qatar, 91.8% were on metformin either alone or in combination with insulin.1 Given the limited data on the effects of metformin exposure in pregnancy, the study aimed to investigate the association between the use of metformin in GDM and the incidence of various maternal and neonatal outcomes. It was hypothesized that metformin use in GDM is not associated with increased incidence of adverse maternal and neonatal outcomes in this high-risk population. This retrospective cohort study looked at women with GDM who sought prenatal care at Sidra Medicine, Doha, Qatar between January 2019 and December 2020 and compared the incidence of various maternal and neonatal outcomes in patients on metformin to those on diet control alone. 649 women with GDM were included in the study; of which 438 were on diet control alone and 211 were on metformin. Women in the metformin group were older and heavier at baseline and gained lesser weight during pregnancy (p<.001). Subjects in the metformin-treated arm had a significantly lower gestational age at delivery (37.8 vs. 38.6 weeks, p<.001), higher incidence of C-section (50.7 vs. 42.2%, p=.042), and higher incidence of polyhydramnios (6.6 vs. 2.1%, p=.003) compared to those in the diet-controlled group. The mean birth weight percentile (66.5 vs. 59.9, p=.008), incidence of large for gestational age (LGA) infants (27 vs. 18%, p=.008) and incidence of neonatal jaundice (1.9 vs. 0.2%, p=.041) in the metformin-treated group were higher, but there was no significant difference in the incidence of other neonatal outcomes between the two groups. In particular, metformin was not associated with increased incidence of preterm labor and small for gestational age (SGA) infants in pregnancy as suggested by previous studies. However, women on metformin had a higher incidence of C-section, polyhydramnios, LGA infants, and neonatal jaundice, and increased mean neonatal weight percentile at birth compared to diet control alone. This could be attributed to the higher degree of maternal hyperglycemia and increased severity of disease in the patients on metformin. In conclusion, our study showed that the use of metformin in GDM is not associated with the increased incidence of preterm labor and SGA infants.

Prevalence and management of neonatal jaundice in a hospital, Jos-Nigeria

Neonatal jaundice (hyperbilirubinemia) is one of the most common conditions that require medical attention in neonates. The medical condition is because of the imbalance between bilirubin production and its excretion. The accumulation of serum bilirubin in excess, elevates the values of bilirubin in neonates up to a high concentration as noted in the medical laboratory assay causing the yellowish colouration of skin and the eye. A retrospective study was carried out in OLA hospital from 2019 t0 2021 for neonates delivered within the period. The incidence of neonatal jaundice (hyperbilirubinemia) in this study was 11.7%. The most common risk factor associated with neonatal jaundice (hyperbilirubinemia) is ABO incompatibility, Preterm gestation and low birth weight (<2.5kg). Neonatal jaundice (hyperbilirubinemia) is a common problem encountered in Neonatal Intensive Care Units of hospitals as seen in OLA Hospital in Jos. The recommended strategies that is involve in the prevention and control of neonatal jaundice include; health education on neonatal jaundice, identification of risk factors, early detection of neonatal jaundice, proper assessment of babies with neonatal jaundice and early referral for good medical management.

Relationship Between Adequacy of Breastfeeding and The Incidence of Neonatal Jaundice in The NICU at Darus Syifa’ Islamic Hospital Surabaya

Inappropriate early breastfeeding is associated with reduced caloric intake and increased serum bilirubin. It occurs due to a lack of caloric intake to increase enterohepatic circulation. Early breastfeeding for neonates can reduce the occurrence of jaundice. This study aimed to determine the relationship between adequacy breastfeeding and the incidence of neonatal jaundice at the Darus Shifa Islamic Hospital Surabaya. This study used an analytical research design with a cross-sectional approach and a purposive sampling method. The population of this study was 35 respondents. The sample in this study was 32 respondents, and there were two variables. The dependent variable was the adequacy of breastfeeding using an instrument on an observation sheet. The independent variable was the incidence of jaundice using a checklist instrument. Data analysis used Spearman rho. The results of the statistical analysis test using the Spearman rho statistic test with the help of SPSS obtained a significance value of p = 000 which means there is a relationship between the adequacy of breastfeeding. The incidence of neonatal jaundice is r =0,912, meaning there is a solid correlation between the adequacy of breastfeeding and the incidence of it. Adequacy breastfeeding is one way to prevent neonatal jaundice with the support of professional health workers' information to mothers about breastfeeding and its benefits. Thereby affecting the continuity of mothers in breastfeeding so that babies do not experience neonatal jaundice.

Hubungan Kelahiran Prematur dengan Kejadian Ikterus Neonatorum pada Bayi Baru Lahir di RSUD

According to data from the World Health Organization (WHO), the infant mortality rate (IMR) in the world in 2012 was 49 per 1000 live births, high risk infant or infant factors that increase the risk of perinatal or neonatal death is one of them is jaundice neonatorum or jaundice. neonatorum is the cause of neonatal death about 20-40% of all deliveries. Based on the results of a preliminary study conducted at the hospital, from 120 cases of premature birth there were 32 cases of neonatal jaundice. This study was to determine the relationship between premature birth and the incidence of neonatal jaundice in newborns. This type of research is correlational analytic with a case control design. The number of samples used in this study is 55 people in the case group and 55 people in the control group. The analysis used is univariate analysis and bivariate analysis. based on the results of statistical test analysis, it was found that in the case group or mothers who experienced premature birth, there were 32 babies (58.2%) who had neonatal jaundice and in the control group or the group of mothers who did not experience premature birth, they got 14.infants or (25.5%) who had neonatal jaundice. the results of the chi square test obtained a p-value of 0.001, it can be concluded that there is a significant relationship between premature birth and the incidence of neonatal jaundice. it is hoped that pregnant women will continue to routinely carry out antenatal care to prevent premature birth, for further researchers to be able to look for other variables related to the incidence of neonatal jaundice.

Hubungan Masa Gestasi dengan Kejadian Ikterus Neonatorum

The Infant Mortality Rate (IMR) in Indonesia has decreased every year, even though it has not yet reached the MDGs target of 23 per 1000 live births. One of the causes of infant mortality in Indonesia is due to neonatal jaundice by 6%. The incidence of neonatal jaundice at Dr. Abdul Aziz Hospital is one of the cases that often occurs every year, in 2019 there were 55 cases out of 912 newborns. The purpose of this study was to determine the relationship between gestational age and the incidence of neonatal jaundice in dr. Abdul Aziz Singkawang hospital. The design of this research is observational analytic with a retrospective approach case control design. The research sample consisted of 60 infants consisting of 30 case samples and 30 control samples. The case sampling technique was consecutive sampling and the control sample was simple random sampling. Data analysis consisted of univariate analysis by calculating percentages and bivariate analysis using chi square test. The results obtained from the chi square test results with a value of ρ value 0.000 < 005, which means that there is a significant relationship between gestational age and the incidence of neonatal infertility.

Correlation of Serum Zinc Level with Hyperbilirubinemia in NeonatesA Case-Control Study

Introduction: Neonatal jaundice is the common cause of hospitalisation in the first month of life. Factors that affect the severity of neonatal jaundice includes maternal, pre-natal, and neonatal factors as well as environmental factors. Zinc (Zn) is one of the factors that affect the severity of neonatal jaundice as it prevents the lipid depolarization of the cell membranes. Hypozincemia may alter the erythrocyte membrane resulting in deficient synthesis of enzymes which play a key role in bilirubin metabolism. Aim: To correlate the serum Zinc level with bilirubin level in neonates with hyperbilirubinemia and also to compare with healthy controls. Materials and Methods: This case-control study was done in Clinical Biochemistry Laboratory of Father Muller Medical College and Hospital, Mangalore, Karnataka, India, from April 2018 to June 2018. Total 60 subjects were included in the study, which was divided into two groups: Neonates with clinically diagnosed hyperbilirubinemia (Group I) and normal healthy neonates as controls (Group II). Serum levels of zinc, total bilirubin, conjugated and unconjugated bilirubin were compared among groups. Correlation among the biochemical parameters was analysed by Karl Pearson’s Correlation Analysis. Results: In present study, 30 subjects were males and 30 females with mean age of 4.90±1.06 days among Group I and 2.50±1.61 days among Group II. This study observed significantly decreased mean levels of serum Zinc (171.24±19.82 μg/dL) in Group I patients when compared to mean levels of serum Zinc (189.23±17.90 μg/ dL) in Group II controls. There was statistically significant positive correlation among serum levels of Zinc and total bilirubin in Group I patients (p<0.05) when compared to Group II. Conclusion: There was statistically significant positive correlation was found among serum levels of Zinc and total bilirubin in cases when compared to healthy controls. Current results showed, zinc may have a protective effect in the incidence of neonatal jaundice.

Maternal and neonatal safety of COVID-19 vaccination during the peri-pregnancy period: A prospective study.

To investigate the safety of inactivated COVID-19 vaccine in Chinese pregnant women and their fetuses when inoculated during the peri-pregnancy period. Eligible pregnant women were prospectively collected and divided into a vaccine group (n = 93) and control group (n = 160) according to whether they had been vaccinated against COVID-19 within 3 months before their last menstruation period (LMP) and after pregnancy. Demographic data of couples, complications during pregnancy and delivery of pregnant women, and data of newborns at birth were collected. Sixty-six women were vaccinated with a median time of 35.5 (range = 0-91) days before LMP, and 27 women were vaccinated with a median time of 17 (range = 1-72) days after LMP. The incidence of premature rupture of membrane (PROM) in the vaccine group was significantly higher than that in the control group (16.13% vs. 6.88%, p = 0.019). Multivariate logistic regression analysis revealed that maternal peri-pregnancy COVID-19 vaccination was not an independent risk factor for PROM (odds ratio: 2.407, 95% confidence interval: 0.932-6.216, p = 0.069). There was no difference in the incidence of other complications during pregnancy and delivery between the two groups. A total of 253 neonates were delivered, including two cases with congenital abnormalities in each group. The incidence of congenital abnormalities between the two groups was similar (2.15% vs. 1.25%, p = 0.626). There was no difference in neonatal length, weight, head circumference, and Apgar score between the two groups (p > 0.05), but the incidence of neonatal jaundice in the vaccine group was significantly higher than that in the control group (20.43% vs. 7.5%, p = 0.002). Multivariate logistic regression analysis revealed that maternal peri-pregnancy vaccination, postpartum blood loss, cesarean section, 1-min Apgar score, and paternal smoking were independent risk factors for neonatal jaundice. It is safe for pregnant women and their fetuses to be inoculated the inactivated COVID-19 vaccine during the peri-pregnancy period, but attention should be paid to neonatal jaundice.

HUBUNGAN USIA GESTASI DAN BERAT LAHIR NEONATUS DENGAN KEJADIAN IKTERUS NEONATORUM DI RSUD DR.M.HAULUSSY AMBON TAHUN 2018-2020

Neonatal jaundice is incident biological on baby that appears because production cell blood red tall and marked low bilirubin excretion with symptom skin colored yellow baby seen weak, urine colored dark until tanned. Reasons neonatal jaundice among other caused because maternal factors, perinatal factors neonate. Study aim for know connection age gestation dan heavy born neonate with jaundice neonatorum at RSUD dr. M. Haulussy Ambon in 2018-2020. Study this is research using design case control, data obtained is secondary data from record medical patients at RSUD dr. M. Haulussy Ambon obtained 154 samples . Data obtained analyzed use Statistical Package for the Social Science (SPSS) 26. Based on the results of the chi-square test, there was a significant relationship between gestational age (p=0.025) and the incidence of neonatal jaundice, as well as neonatal birth weight (p=<0.001). M. Haulussy Ambon 2018-2020.

Assessment, management, and incidence of neonatal jaundice in healthy neonates cared for in primary care: a prospective cohort study

Jaundice caused by hyperbilirubinaemia is a common phenomenon during the neonatal period. Population-based studies evaluating assessment, management, and incidence of jaundice and need for phototherapy among otherwise healthy neonates are scarce. We prospectively explored these aspects in a primary care setting via assessing care as usual during the control phase of a stepped wedge cluster randomised controlled trial.We conducted a prospective cohort study embedded in the Screening and TreAtment to Reduce Severe Hyperbilirubinaemia in Infants in Primary care (STARSHIP) Trial. Healthy neonates were included in seven primary care birth centres (PCBCs) in the Netherlands between July 2018 and March 2020. Neonates were eligible for inclusion if their gestational age was ≥ 35 weeks, they were admitted in a PCBC for at least 2 days during the first week of life, and if they did not previously receive phototherapy. Outcomes were the findings of visual assessment to detect jaundice, jaundice incidence and management, and the need for phototherapy treatment in the primary care setting.860 neonates were included of whom 608 (71.9%) were visibly jaundiced at some point during admission in the PCBC, with 20 being ‘very yellow’. Of the latter, four (20%) did not receive total serum bilirubin (TSB) quantification. TSB levels were not associated with the degree of visible jaundice (p = 0.416). Thirty-one neonates (3.6%) received phototherapy and none received an exchange transfusion. Five neonates did not receive phototherapy despite having a TSB level above phototherapy threshold.Jaundice is common in otherwise healthy neonates cared for in primary care. TSB quantification was not always performed in very jaundiced neonates, and not all neonates received phototherapy when indicated. Quality improvement initiatives are required, including alternative approaches to identifying potentially severe hyperbilirubinaemia.Trial registration: NL6997 (Dutch Trial Register; Old NTR ID 7187), registered 3 May 2018.

Incidence and Risk Factors to Neonatal Jaundice in Jalingo, Taraba State

This cross-sectional study was aimed to determine the incidence and the significant risk factors to neonatal jaundice in FMC, Jalingo. Four hundred and thirty three neonates admitted to special baby care unit (SBCU) FMC, Jalingo with their mothers were surveyed. Data were collected through a data extraction format looking on the medical records of the neonates (from 1st January, 2021 to 31st August, 2021) and interviewing the mothers. Data were transferred to an Excel data sheet and results were summarized by frequencies and percentages (categorical variables). Logistic regression analysis was used to determine the strength of the risk factors to neonatal jaundice while the significance was tested at p-value ≤ 0.05. The findings revealed that the incidence of neonatal jaundice in FMC Jalingo was 40.18% while the significant risk factors were age group 41 - 50 years (I = 15.01%, OR: 2.970 at 95% CI: 1.566 - 5.634, p = 0.000), spontaneous vaginal delivery (I = 18.01%, OR: 1.382 at 95% CI: 0.940 - 2.033, p = 0.000), premature rupture of membrane (I = 24.94%, OR at: 2.252 at 95% CI: 1.520 - 3.337, p = 0.000), hypertension in pregnancy (I = 21.02%, OR: 1.831 at 95% CI: 1.240 - 2.703, p = 0.002). Others were breech fetal presentation (I = 23.33%, OR: 2.689 at 95% CI: 1.809 - 3.995, p = 0.000), birth asphyxia (I = 22.40%, OR: 3.469 at 95% CI: 2.3105.210, p = 0.000), significant bruising (I = 22.86%, OR: 1.705 at 95% CI: 1.157 - 2.513, p = 0.007), neonatal sepsis (I = 21.02%, OR: 1.688 at 95% CI: 1.145 - 2.488, p = 0.008) and congenital hemolytic anemia (I = 21.71%, OR: 1.723 at 95% CI: 1.169 - 2.540, p = 0.006). Therefore, the need for all concerned to ensure the incidence is reduced and the risk factors identified early and tackled.

Neonatal Screening for Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency in Eastern India

Introduction: The overall magnitude of the frequency of G6PD deficiency ranges between 0 to 10 percent in the Indian population. This prospective study was planned to estimate the prevalence of G6PD deficiency in newborn population born in a tertiary care centre in Eastern India. Methods: This prospective observational study was undertaken among all consecutively delivered neonates born in a tertiary care teaching hospital of Eastern India, between Apr 2016 and Oct 2017. Prematurity less than 32 weeks and perinatal asphyxia requiring extensive resuscitation were excluded from the study. Umbilical cord blood samples were collected in a EDTA containers, drawn from the placental side of the umbilical cord incised while severing it at the time of birth. The G6PD levels were estimated quantitatively based on ultraviolet (UV) method by quantitative sphectrophotometric assay using ILab 650 fully automated analyzer. All babies wherein the cord blood G6PD levels was less than 6.95 mU/g of Hb was taken as deficient. Results: Mean (SD) of G6PD at birth was 12.56 (3.45) mU/g of Hb. Out of 1037 neonates, five were found to be G6PD deficient. There was increased incidence of neonatal jaundice requiring phototherapy in G6 PD deficient neonates, and it was statistically significant. Conclusion: The prevalence of G6PD deficiency was 0.48% in term and late preterm neonates as assessed quantitatively in cord blood

Relationship between vitamin D levels in mother’s blood and neonatal umbilical cord with jaundice in neonates

Introduction: In neonates, jaundice is the result of an imbalance between the production and conjugation of bilirubin. Overall, about 60% of full-term neonates experience jaundice in the first week of life. Metabolism of bilirubin and vitamin D occurs in two separate pathways, but because one stage of their production happens in liver, they may affect each other. Objectives: Diagnostic and therapeutic assays are based only on the opinion of obstetricians and gynecologists. The possible results of this study may help to explain preventive methods. In this study, we will evaluate the relationship between serum levels of vitamin D in the mother’s blood and the baby’s umbilical cord with the occurrence of neonatal jaundice. Patients and Methods: This prospective study (cohort) was performed on 110 mothers and their newborns in Firoozabadi hospital in Shahr-e Ray. The sampling method was non-probability convenience. Data including maternal age, nationality, gravidity, gestational age, maternal diseases such as chronic the liver and kidney disease, diabetes mellitus, hypertension and the use of anticonvulsant drugs were obtained from the maternity delivery records and mothers who did not meet the inclusion criteria were excluded at first. Maternal blood samples during labor and neonatal umbilical cord samples were used for assaying the serum levels of 25-hydroxy vitamin D, calcium (Ca) and phosphorus (P), alkaline phosphatase (ALP). All neonates visited for jaundice on days 7 and 14 after birth and tested for bilirubin levels if jaundice was observed. Results: There was no significant difference between neonates with normal and abnormal vitamin D levels in terms of jaundice on day 7 (P=0.571). Additionally, there was not a significant relationship between mothers with normal and abnormal vitamin D levels in terms of jaundice on day 7 in their neonates (P=0.587). However, a statistically significant relationship between normal vitamin D levels in mothers with jaundice in their neonates on day 14 (P=0.003) was detected. There was a significant relationship between normal maternal vitamin D with the incidence of neonatal jaundice on day 14 (relative risk = 0.32). In addition, evaluation of the relationship between normal and abnormal vitamin D levels in neonates with 14th day jaundice revealed no statistically significant relationship between the two groups of normal and abnormal (P=0.1). Mean serum ALP concentration in mothers of neonates who did not develop jaundice was significantly higher than mothers of neonates with severe jaundice (bilirubin >15 mg/ dL) (P=0.02). First minute Apgar score in neonates who had no jaundice or developed mild jaundice was significantly higher than neonates with severe jaundice (bilirubin >15 mg/dL) (P=0.026). Conclusion: Overall, in this study, no significant relationship was observed between neonatal 7th day jaundice with maternal and neonatal vitamin D levels. There was a significant relationship between maternal normal serum vitamin D levels with neonatal 14th day jaundice.

Pengaruh Pemberian Air Susu Ibu dan Fototerapi terhadap Ikterus Neonatorum di Ruang Perinatologi RSUD Pasaman Barat

Neonatal jaundice is a common problem in the care of normal newborns. West Pasaman Regional Hospital data states that in 2018 there were 41 cases of neonatal jaundice out of 369 deliveries. The research objective was to determine the effect of exclusive breastfeeding and phototherapy on the incidence of neonatal jaundice. The research method is retrospective, namely conducting research on past events. The research was conducted at RSUD Pasaman Barat with a population of 20 people. Sampling was done by total sampling technique, so that the sample size is 20 people. Data collection was carried out by means of observation at the West Pasaman Regional Hospital. The approach used is cross sectional, namely independent and dependent data collection is done at the same time. The data that has been collected is then processed manually and analyzed by computerized univariate and bivariate analysis. This type of research is descriptive with a cross sectional design. The study population was all babies in West Pasaman Regional Hospital with a total of 41 people, the sample size was determined by the total sampling so that the sample was 41 people. The data was collected by means of a documentation study using a checklist. Data processing was carried out by univariate computerization. The results showed that as many as 13 respondents (31.7%) were breast-fed, 63.4% were carried out with phototherapy and 24.4% of respondents had neonatal jaundice. Based on the bivariate analysis obtained p value 0.049 (Breastfeeding) and 0.001 (Phototherapy). The results of the Chi Square test, it can be concluded that there is an effect of breastfeeding and phototherapy on the incidence of neonatal jaundice

<p>Effect of Delayed Cord Clamping at 30 Seconds and 1 Minute on Neonatal Hematocrit in Term Cesarean Delivery: A Randomized Trial</p>

ObjectiveTo compare the effect of delayed cord clamping at 30 seconds and 1 minute on the incidence of neonatal hematocrit, anemia, maternal and neonatal complications in term cesarean delivered neonates.MethodsAn opened labelled, randomized controlled trial was undertaken. The 160 healthy term cesarean-born neonates were randomly allocated to either 30 seconds or 1-minute groups of delayed cord clamping (DCC) (groups 1 and 2). Neonatal venous hematocrit (Hct) and microbilirubin (Mb) were measured at 48–72 hours after birth.ResultsOne hundred and fifty-nine neonates completed this study. Mean neonatal hematocrit ± standard deviation at 48–72 hours was 49.9 ± 6.0% in group 1 and 51.2 ± 5.9% in group 2 without a statistical difference. Neonatal anemia (Hct less than 45%) occurred in 14/79 neonates (17.7%) in group 1 and in 8/80 cases (10.0%) in group 2 without a significant difference between groups. The incidence of neonatal jaundice and polycythemia (hematocrit more than 65%) was similar between groups. There were no significant differences; in the estimated blood loss during the operation, the incidence of postpartum hemorrhage and other maternal and neonatal complications.ConclusionNeonatal hematocrit was not significantly different following DCC at 30 seconds and at 1 minute, but the incidence of neonatal anemia decreased with the longer timing of DCC. The estimated blood loss and other complications were not different between the two groups. Therefore, one minute-DCC should be considered for neonatal anemic prevention when compared with 30 seconds-DCC.

Faktor Risiko Yang Berhubungan Dengan Kejadian Ikterus Neonatorum Pada Bayi Baru Lahir

Ikterus neonatorum merupakan masalah kesehatan yang sering ditemukan di antara bayi baru lahir (BBL) pada minggu pertama kehidupannya, jika tidak ditangani sejak dini dapat berakibat fatal bahkan kematian. Penelitian ini bertujuan untuk mengetahui faktor risiko yang berhubungan dengan kejadian ikterus neonatorum pada BBL. Penelitian yang bersifat analitik korelatif dengan pendekatan cross sectional ini dilakukan terhadap 188 BBL, diambil dengan sistematik random sampling. Data diperoleh dari rekam medik dan dianalisis menggunakan uji Chi-square. Hasil penelitian diperoleh 82 (43,6%) BBL mengalami ikterus neonatorum, dengan 42 (71,2%) BBL dari 59 BBL dengan riwayat persalinan induksi oksitosin mengalami ikterus neonatorum, 24 (68,6 %) BBL dari 35 BBL prematur mengalami ikterus neonatorum dan 48 (35,3%) BBL dari 136 BBL yang diberi ASI mengalami ikterus neonatorum. Kesimpulan penelitian ini yaitu ikterus neonatorum lebih berpeluang terjadi pada BBL dengan riwayat persalinan induksi oksitosin, BBL prematur dan BBL yang diberi ASI. Petugas kesehatan yang berwenang diharapkan meminimalkan tindakan induksi oksitosin dan melakukan perawatan intensif sesuai prosedur pada BBL.

Contribution of information technology (IT) system in overcoming neonatal jaundice: a systematic literature review

Information technology systems can improve efficiency, quality of service, security and improve the quality of diagnosis, especially in the incidence of neonatal jaundice, because the incidence of jaundice that is not monitored can cause increasingly severe problems so that it can cause kernicterus and can also cause death in neonatal. This paper is focused on analyzing the contribution of information technology systems to health problems especially neonatal jaundice. The study design uses a systematic literature review with international journals in electronic databases. Journal criteria used the Randomized Controlled Trial (RCT) technique from 2011-2019. This systematic literature review concludes that information technology systems have a role in health care, wherefrom several technologies have proven to be able to detect, diagnose, treatment and education that is easy, fast, effective and can be used whenever needed in overcoming the problem of neonatal jaundice. However, the use of information technology systems has not been comprehensive so that it needs development especially in areas with limited access.

Faktor Risiko Kejadian Ikterus Neonatorum

ABSTRAKPendahuluan: Ikterus neonatorum merupakan manifestasi klinis pada neonatus yang ditandai dengan warna kuning pada kulit dan sklera akibat dari akumulasi produksi bilirubin tak terkonjugasi yang berlebih dalam jaringan. Berdasarkan data di RSUD Dr. Soetomo, tepatnya di ruang NICU dari 844 neonatus (46,8%) mengalami ikterus neonatorum. Tujuan penelitian ini adalah untuk menganalisis faktor risiko yang berhubungan dengan kejadian ikterus neonatorum.Metode: Desain penelitian menggunakan analitik observasional dengan pendekatan case control. Sampel yang digunakan sebanyak 84 neonatus. Teknik pengambilan sampel menggunakan sequential sampling. Variabel independen yaitu inkompatibilitas ABO, prematuritas, BBLR, asfiksia, dan riwayat ibu DM, sedangkan variabel dependen adalah ikterus neonatorum. Pengumpulan data berupa data sekunder dari neonatus dan ibu. Analisis data menggunakan Contingency coefficient dengan α=0,05.Hasil: Hasil penelitian menunjukkan 85,7% neonatus yang inkompatibilitas ABO mengalami ikterus neonatorum dan didapatkan nilai p=0,048, OR=6.833. Terdapat 57,4% neonatus yang prematur mengalami ikterus neonatorum dan didapatkan nilai p=0,028, OR=3,077. Terdapat 42,4% BBLR yang mengalami ikterus neonatorum dan didapatkan nilai p=0,032, OR=0,346. Terdapat 60% neonatus yang asfiksia mengalami ikterus neonatorum dan didapatkan nilai p=0,500. Terdapat 85,7% riwayat Ibu DM yang mengalami ikterus neonatorum dan didapatkan nilai p=0,048, OR=6,833.Kesimpulan: Kesimpulan penelitian ini, terdapat hubungan antara inkompatibilitas ABO, prematuritas, BBLR, dan riwayat Ibu DM dan tidak ada hubungan antara asfiksia dengan kejadian ikterus neonatorum di RSUD Dr. Soetomo.

Growth Patterns of Neonates Treated with Thermal Control in Neutral Environment and Nutrition Regulation to Meet Basal Metabolism.

Little is known about the growth patterns of low birth weight neonates (<2500 g) during standardized thermal control and nutrition regulation to meet basal metabolism requirements compared to those of non-low birth weight neonates (2500 g and above). We retrospectively identified 10,544 non-low birth weight and 681 low birth weight neonates placed in thermo-controlled incubators for up to 24 h after birth. All neonates were fed a 5% glucose solution 1 h after birth and breastfed every 3 h (with supplementary formula milk if applicable) to meet basal metabolism requirements. Maximum body-weight loss (%), percentage body-weight loss from birth to peak weight loss (%/day), and percentage body-weight gain from peak weight loss to day 4 (%/day) were assessed by multivariable linear regression. Overall, the growth curves showed a uniform J-shape across all birth weight categories, with a low mean maximum body-weight loss (1.9%) and incidence of neonatal jaundice (0.3%). The body-weight loss patterns did not differ between the two groups. However, low birth weight neonates showed significantly faster growth patterns for percentage body-weight gain: β = 0.52 (95% confidence interval, 0.46 to 0.58). Under thermal control and nutrition regulation, low birth weight neonates might not have disadvantages in clinical outcomes or growth patterns.