Neonatal Pathological Jaundice Research Articles

The Association Between Asphyxia and Neonatal Pathological Jaundice Incidence in Umbu Rara Meha Hospital East Sumba Regency

Jaundice causes 70% morbidity and 10% infant mortality worldwide, approximately 1.1 million newborns are affected by jaundice every year. The purpose of this study was to analysis the association between asphyxia and the incidence of neonatal pathological jaundice at Umbu Rara Meha Hospital, East Sumba Regency. The research used a quantitative method with case and control approach using secondary collection data medical records from January to October 2023. The sample ratio was 1:1, the case group sample is 75 babies with jaundice and the control group sample is 75 babies who were born in the hospital. The sampling taken by consecutive sampling. The analysis used the Chi-square test. The data analysis showed there was an association between asphyxia and neonatal pathological jaundice incidence with p=0.001. The data result showed there was an association between asphyxia and neonatal pathological jaundice incidence at Umbu Rara Meha Hospital, East Sumba Regency.

Incidence of prolonged transitional neonatal hypoglycemia and associated factors among neonatal admissions in South Gondar public hospitals, North-Central Ethiopia: a prospective cross-sectional study.

Unlike in developed countries, neonatal morbidity and mortality are the leading challenges associated with easily preventable and treatable disorders during the neonatal period in low- and middle-income countries. However, evidence-based data about prolonged transitional hypoglycemia and associated factors are highly limited in Ethiopia and resource-limited countries. An institution-based prospective cross-sectional study was conducted at public hospitals in South Gondar in neonatal intensive care units (NICUs). The data were entered and analyzed using SPSS version 23. Descriptive statistics were used to summarize maternal characteristics. Multivariate binary logistic regression at a p value <0.05 was used. A total of 400 neonates, admitted to NICUs in public hospitals within 48-72 h of birth between October 2, 2021, and June 30, 2022, were included in the study. The incidence of prolonged transitional neonatal hypoglycemia (PTHG) was 23.5% (19.3%-28%). The factors associated with PTHG were hypothermia (AOR = 4.41; 95% CI = 2.72-10.92), preterm birth (AOR = 3.5; 95% CI = 1.69-11.97), perinatal asphyxia (AOR = 2.5; 95% CI = 1.34-9.67), and pathological jaundice (AOR = 2.3; 95% CI = 1.21-10.34). In contrast, spontaneous vaginal delivery (SVD) was a protective factor (AOR = 0.72; 95% CI = 0.35-0.88). The incidence of (PTHG) was nearly one-fifth. Factors increasing the risk of PTHG were hypothermia, preterm birth, perinatal asphyxia (PNA), early onset of sepsis (EONS), and pathological jaundice. Spontaneous vaginal delivery (SVD) was also a protective factor. Preventing neonatal hypothermia was the main measure used to reduce PTHG in the study area. Special attention could be given to neonates with prematurity, early onset neonatal sepsis (EONS), birth asphyxia, and pathological jaundice, as monitoring their RBS could lead to a significant change in reducing PTHG.

Maternal blood parameters and risk of neonatal pathological jaundice: a retrospective study

This study aims to investigate the association between maternal blood parameters and the risk of neonatal pathological jaundice. A retrospective case–control study of 1309 newborns and their mothers from 2019 to 2020 in a single-center tertiary hospital. All mothers received a complete routine blood test prior to delivery, and outcome was neonatal pathological jaundice. We performed stepwise logistic regression modeling to identify maternal blood factors associated with neonatal pathological jaundice. 258 neonates (19.71%) were diagnosed with pathological jaundice. Logistic regression results showed that the odds ratio for pathological jaundice in neonates of mothers with high white blood cell (WBC) count was 1.512 (95% CI 1.145–1.998; P = 0.004). Besides, neonates whose mothers had a high mean corpuscular volume (MCV) during pregnancy doubled the odds of developing pathological jaundice (OR = 1.967; 95% CI 1.043–3.711; P = 0.037). Among neonates, those whose mothers had high levels of WBC count and MCV were at increased risk of pathological jaundice. Regular obstetric examinations and routine blood tests are essential to initiate adapted care.

Interval Type-2 Fuzzy Analysis and Comprehensive Evaluation for Neonatal Pathological Jaundice

Neonatal pathological jaundice (NPJ) is easy to cause bilirubin encephalopathy, which has high mortality and sequelae rate. Therefore, accurate risk evaluation can help clinicians take appropriate measures to timely intervene in neonatal jaundice level and avoid complications. In this article, five indexes are extracted as the factor set for the risk evaluation of NPJ, and the diagnostic criteria are determined. Then, five index sets are described by interval type-2 fuzzy sets, and the corresponding membership functions and membership function figures are provided. The feasibility of interval type-2 fuzzy comprehensive evaluation in risk evaluation of NPJ is demonstrated through example, and the fuzzy rule bases of prevention and treatment for NPJ are constructed according to the results of risk evaluation. Finally, this article demonstrates that the proposed risk evaluation and treatment process of NPJ is actually a dynamic closed-loop control process, which is consistent with the clinical treatment process. This article provides a new solution for the aided diagnosis and decision-making treatment of NPJ, which is of great significance in reducing neonatal mortality and alleviating the pressure of medical staff.

Risk factors of realization and clinical and laboratory features of the course of prolonged neonatal pathological jaundice in premature newborns

Risk factors of realization and clinical and laboratory features of the course of prolonged neonatal pathological jaundice in premature newborns

Efficacy and Safety of Yinzhihuang Granule Combined with Phototherapy in Neonatal Pathological Jaundice Treatment: A Meta-Analysis

To assess the efficacy and safety of Yinzhihuang granule combined with phototherapy in neonatal pathological jaundice treatment. By searching China network knowledge infrastructure, Wan Fang database, Virtual IP address database, Virtual IP, PubMed, EmBase together with the Cochrane library until March 31st, 2022. Literatures on Yinzhihuang combined with phototherapy in neonatal pathological jaundice treatment were collected. Literatures were screened by the inclusion and exclusion criteria and data were extracted. A total of 19 literatures were included in this study, a total of 2221 neonates with pathological jaundice. The outcomes of metaanalysis demonstrated the total clinical effective rate of Yinzhihuang combined with phototherapy in neonatal pathological jaundice treatment was significantly higher than that of phototherapy. At the end of one course of treatment, the total bilirubin level was significantly lower than that of the phototherapy group. The recovery time and hospital stay were shorter than those in the phototherapy group. The occurrence rate of adverse reactions was reduced compared to that of phototherapy group and the difference was significant. Yinzhihuang granule combined with phototherapy in neonatal pathological jaundice treatment has better clinical effect and safety.

Effects of group B streptococcus infection on vaginal micro-ecology and pregnancy outcomes of pregnant women in late pregnancy

BackgroundInvasive infection with group B streptococcus (GBS) can lead to intrauterine infection, and GBS can also spread via vertical transmission between mother and infant, resulting in adverse pregnancy outcomes. This study aimed to investigate the effects of GBS colonization in late gestation on vaginal micro-ecology, pregnancy outcomes and neonatal outcome. MethodsOne hundred and twenty pregnant women in the third trimester infected with GBS and 120 healthy counterparts who underwent a prenatal examination in the obstetrics department of the study hospital from June 2019 to December 2020 were selected for inclusion in the study. Vaginal micro-ecological index, mode of delivery, adverse pregnancy outcomes and neonatal Apgar score were compared between the two groups. ResultsThe incidence rates of vaginal micro-ecological disorders, intrauterine infection and neonatal infection were significantly higher in the GBS group compared with the control group. The incidence rates of neonatal fetal distress and pathological jaundice were much higher in the GBS group compared with the control group. The neonatal Apgar score was markedly lower in the GBS group compared with the control group. ConclusionsGBS infection is correlated with the vaginal micro-environment. GBS colonization in late pregnancy has adverse effects on vaginal micro-ecology and pregnancy outcome.

Evaluation of Associated Markers of Neonatal Pathological Jaundice Due to Bacterial Infection.

Background:To evaluate changes of associated markers in neonatal pathological jaundice due to bacterial infection in newborns, to provide an experimental basis for early diagnosis and treatment of neonatal pathological jaundice.Methods:A total of 126 newborns with neonatal pathological jaundice in the Pediatrics Department of Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University from Jan 2016 to Jun 2018 were enrolled. The patients were divided into bacterial infection group (76 cases with combined bacterial infection) and non-infection group (50 cases without bacterial infection). Peripheral blood was drawn from patients, and levels of inflammatory factors, levels of indexes of liver function and levels of cardiac markers were detected. Correlation between inflammatory factors and neonatal pathological jaundice was assessed.Results:The levels of WBC, hs-CRP and PCT in the bacterial infection group were significantly higher than those in the non-infected group (P<0.05). The level of TRF in the bacterial infection group was significantly lower than that in the non-infection group (P<0.01). In the bacterial infection group, the levels of WBC, hs-CRP, PCT, and TRF were positively correlated with the levels of CK, CKMB, LDH, and α-HBDB, respectively (all P<0.05). The TRF level after treatment was significantly higher than that before treatment (P<0.01).Conclusion:Markers such as WBC, hs-CRP, PCT, and TRF can be used as effective indicators in diagnosis of pathological jaundice due to bacterial infection in newborns. The combined testing of WBC, hs-CRP, PCT, and TRF was helpful for early diagnosis and early clinical intervention of neonatal pathological jaundice, which can lower the risk of clinical complications.

Evaluation of Procalcitonin and C-reactive Protein in Early Differential Diagnosis of Neonatal Jaundice.

The purpose of this study was to investigate the clinical value of procalcitonin (PCT) and C-reactive protein (CRP) in the differential diagnosis of neonatal jaundice. Eighty-five cases of neonatal jaundice in our hospital from January 2016 to March 2019 were selected as research subjects, including 30 cases of physiological jaundice, 23 cases of infectious jaundice, and 32 cases of he-molytic jaundice. Five milliliters of non-anticoagulated venous peripheral blood and 3 mL EDTA-K+ anticoagulated venous peripheral blood were sampled from each newborn when the symptoms of jaundice occurred. The non-anticoagulated blood samples were then centrifuged at 3,500 rpm for 7 minutes and the serum was used for PCT and bilirubin examinations, and the anticoagulated blood samples were prepared for CRP examination. Receiver operating characteristic (ROC) curve analysis was performed for the evaluation of differential diagnosis of neonatal jaundice by PCT, CRP, and bilirubin levels. Analyses of variance showed the postnatal age of jaundice occurring in the physiological jaundice group was older than those in the infectious jaundice and hemolytic jaundice groups (p < 0.001), and the PCT and CRP levels in the infectious jaundice group were higher than those in the hemolytic jaundice and physiological jaundice groups (p < 0.001). Pearson's correlation analysis indicated that the levels of PCT and CRP were negatively correlated with postnatal age in the physiological jaundice group (p < 0.05). ROC curve analysis demonstrated that PCT and CRP had the highest differential diagnosis efficacy of neonatal pathological and neonatal physiological jaundice with PCT and CRP at 0.70 µg/L and 8.50 mg/L, respectively, as well as the highest differential diagnosis efficacy of neonatal infectious jaundice and neonatal hemolytic jaundice with PCT and CRP at 1.84 µg/L and 13.50 mg/L, respectively. This study suggested that PCT and CRP possessed important clinical values in the differential diagnosis of neonatal jaundice, and PCT was superior to the differential diagnosis of neonatal infectious jaundice.

Cord blood bilirubin, albumin, and bilirubin /albumin ratio for predicting subsequent neonatal hyperbilirubinemia

Background Early discharge of healthy term newborns after delivery has become a common practice, because of medical and social reasons, as well as economic constraints. Thus, the recognition, follow-up, and early treatment of jaundice has become more difficult as a result of early discharge from the hospital. Since the dreaded complication of neonatal hyperbilirubinemia is kernicterus, an investigation which can predict the future onset of neonatal pathological jaundice is needed.&#x0D; Objective To investigate the predictability of neonatal hyperbilirubinemia by using cord blood bilirubin, albumin and bilirubin/albumin ratio.&#x0D; Methods This study was conducted on 300 healthy newborns. Umbilical cord blood was used to measure albumin and bilirubin. All infants were regularly followed up to 5th day of life. Neonates were divided into two groups: group A was consisted of neonates who developed jaundice which was in physiological range, while group B was consisted of neonates who developed neonatal hyperbilirubinemia (requiring phototherapy or other modality of treatment). Babies suspected to have bilirubin level which cross physiological limit on any day after birth were subjected to serum bilirubin measurement. Infants whose serum bilirubin level measurement revealed bilirubin levels crossing physiological values were sent to nursery for phototherapy.&#x0D; Results The incidence of neonatal hyperbilirubinemia was 11%. Statistically significant correlations between cord blood bilirubin, albumin, and bilirubin/albumin ratio to the development of neonatal hyperbilirubinemia were observed. On ROC analysis, cut-off points to predict significant hyperbilirubinemia in newborn were cord blood bilirubin &gt;3 mg/dL (sensitivity 60.61%, specificity 97.63%), albumin &lt;2.4 mg/dL (sensitivity 78.79%, specificity 98.13%), cord blood bilirubin/albumin ratio &gt;0.98 (sensitivity 78.79%, specificity 95.51%).&#x0D; Conclusion Cord blood total bilirubin, albumin. and bilirubin/albumin ratio are excellent parameters to predict the occurrence of neonatal hyperbilirubinemia. However, cord blood albumin is better compared to cord blood bilirubin and bilirubin/albumin ratio.

Study of incidence of breastfeeding failure jaundice in cases of neonatal hyperbilirubinemia in a suburban hospital

Background: Neonatal jaundice is the most common cause of readmission after discharge from birth hospitalization. Breastfeeding failure jaundice (BFFJ) is an important subtype of pathological neonatal jaundice. It typically occurs with lactation failure during the first postnatal week that leads to insufficient intake, dehydration, weight loss and sometimes hypernatremia. Incidence of breast-feeding failure is expected to rise as the exclusive breast-feeding rates are rising. This problem is not well studied especially in Indian setting hence study was conducted.Methods: This was retrospective observational study done in Department of Pediatrics from the April 1, 2016 to March 31, 2018. 179 neonates, who presented with jaundice as main complaint with total bilirubin value above the age &amp; risk factor matched cut off, were sampled and their clinical data was analyzed.Results: Breast feeding failure jaundice contributed 31.8% (N = 57) cases, second to the exaggerated physiological hyperbilirubinemia (48% N = 86), followed by hemolytic (13.8%, N = 25). BFFJ presented at median age of 6.8 days and had mean duration of hospital stay of 3 days. Incidences of exaggerated physiological jaundice and BFFJ were found to be higher in winter months i.e. 6.7% (N = 48/716) compared to summer months i.e. 4.1% (N = 28/679) significantly (p value = 0.045).Conclusions: Breast feeding failure jaundice (BFFJ) contributed to one third of cases of neonatal pathological jaundice requiring re-admission and is the second most common cause after exaggerated physiological jaundice. The high incidence of BFFJ in the study warrants focused efforts for a structured program of breast-feeding education, training and surveillance.

Timing and mode of delivery for uncomplicated twin pregnancies

Objective To investigate the relationship between time and mode of delivery and gestational outcomes in uncomplicated twin pregnancies. Methods A total of 347 women with uncomplicated twin pregnancies who gave birth in First Affiliated Hospital of Sun Yat-Sen University between November 2012 and June 2015 were reviewed retrospectively, including 291 dichorionic diamniotic twin pregnancies (DCDA) and 56 monochorionic diamniotic twin pregnancies (MCDA). The general information, gestational complications, time and mode of delivery, gestational outcomes were recorded and the relationship between time and mode of delivery and gestational outcomes in DCDA and MCDA groups were analyzed. T test, Chi-square, Fisher's exact test and logistic regression analysis were used for statistical analysis. Results (1) The incidence of adverse neonatal outcomes in DCDA group [49.1% (281/572)] was significantly lower than in MCDA group [75.5% (83/110)] (χ2=25.698, P<0.05). In DCDA group, women delivered at 36-36+6 weeks, 37-37+6 weeks and 38-38+6 weeks had lower rates of admission to neonatal intensive care unit (NICU), neonatal respiratory distress syndrome (NRDS) and other neonatal diseases than those delivered at <34 weeks, 34-34+6 weeks and 35-35+6 weeks (all P<0.05), while those delivered at 38-38+6 weeks had a higher incidence of pathological jaundice (2/8) than at 36-36+6 weeks and 37-37+6 weeks (3.1% and 1.9%) (χ2=10.133 and 13.510, both P<0.05). In MCDA group, the rate of admission to the NICU decreased gradually from 100.0% (30/30) (<35 weeks) to 3/12 (37-37+6 weeks) (P<0.05). In DCDA group, the odds ratio (OR) and 95% confidence interval(95%CI) of adverse neonatal outcomes in 35-35+6, 36-36+6 and 37-37+6 weeks were 0.237(0.116-0.482), 0.056(0.029-0.108) and 0.054(0.026-0.112), respectively (all P<0.05). In MCDA group, OR (95%CI) of adverse neonatal outcomes in 34-34+6 and 35-35+6 weeks were 38.894 (3.084-490.552)and 18.858 (1.538-231.222), respectively (both P<0.05). (2) With regard to mode of delivery, ten cases of DCDA and two cases of MCDA had vaginal deliveries. In DCDA group who gave birth at less than 34 weeks, the incidence of neonatal pathological jaundice in vaginal delivery group (8/14) was higher than that in cesarean delivery group [22.7% (15/66)] (χ2=5.104, P=0.024). Conclusions The optimal time of delivery for uncomplicated twins is 36-37+6 weeks. The appropriate mode of delivery should be determined by the status of both the mother and the twins. Key words: Pregnancy, twin; Pregnancy complications; Parturition; Delivery, obstetric; Pregnancy outcome

Analysis of Etiology, Diagnosis and Treatment of Neonatal Pathological Jaundice

&lt;strong&gt;Objectives: &lt;/strong&gt;To investigate the causes of neonatal pathological jaundice and provide the basis for clinical diagnosis and treatment. &lt;strong&gt;Method: &lt;/strong&gt;The clinical data of 120 cases of neonatal jaundice were analyzed retrospectively. &lt;strong&gt;Results: &lt;/strong&gt;In the cause of the disease, 22 cases of neonatal asphyxia, accounting for 21, 17.50% cases of breast feeding, accounting for 13, 10.83% cases of ABO hemolytic disease, accounting for 24.17%, 8 cases of cesarean section, accounting for 6.67%, 5 cases of premature delivery, accounting for 4.17%, 6 cases of intracranial hematoma, accounting for 5%. Infection, breast feeding, neonatal asphyxia, ABO blood group incompatibility is an independent factor. 120 cases were cured and discharged. No serious sequelae and dysfunction occurred. &lt;strong&gt;Conclusion: &lt;/strong&gt;To strengthen the perinatal health care, and pay attention to the prevention and treatment of risk factors, such as infection, neonatal asphyxia, and the use of appropriate breast feeding, can effectively reduce the incidence of neonatal pathological jaundice.

Risk factors for paternal vertical transmission of hepatitis B virus.

To explore the risk factors of and the influence of different hepatitis B virus (HBV) DNA load on paternal vertical transmission of HBV. Totally, 161 HBsAg negative women, whose husband was HBsAg positive, attended the antenatal clinics of the Provincial Maternity and Child Health Hospital of Fujian from September 2007 to December 2008 and their newborns were selected, and the epidemiologic information, the duration of being a HBV carrier, the first class HBV family history of the fathers, HBV markers, HBV DNA load, HBsAb of the gravidas, the outcomes of the newborns were all collected. Cord blood was sampled after delivery for HBV DNA quantification and those with HBV DNA load >/= 1.0 x 10(3) copy/ml were chosen as the case group and those < 1.0 x 10(3) copy/ml as control. (1) Among the 161 newborns, 36 HBV DNA positive cord blood samples were detected, giving a rate of 22.4% (36/161) for paternal vertical transmission of HBV. The HBV DNA positive rate in cord blood was 32.0% (23/72) in HBeAg-positive fathers and 14.6% (13/89) in HBeAg-negative fathers. (2) Univariate analysis showed that HBeAg-positive, HBV DNA positive, first class family history of HBV and the duration of being a HBV carrier of the fathers were risk factors of paternal HBV vertical transmission [chi(2) = 6.892, 29.916, 29.499 and 23.821, OR = 2.7, 5.2, 8.3 and 1.4 (P < 0.01)]. (3) Multivariate analysis found that paternal serum HBV DNA positive and the first class family history of HBV of the father side were risk factors of paternal vertical transmission of HBV (OR = 11.1, 95%CI: 4.6 - 27.1; OR = 17.1, 95%CI: 3.5 - 82.6). (4) According to the different serum HBV DNA load of the HBsAg-positive father, 7 groups were divided. A dose dependent effect was found that the HBV DNA positive rate of the cord blood increased with the rising of HBV DNA load. No HBV DNA positive cord blood was detected when paternal HBV DNA load was < 1.0 x 10(4) copy/ml, while 100% of the cord blood were positive when paternal HBV DNA load >/= 1.0 x 10(8) copy/ml. (5) The average birth weight of the newborns in the two groups was the same (3.3 +/- 0.4) kg. And the delivery mode, gestational age at delivery, height and Apgar score of the newborns at 1 minute, neonatal pathological jaundice and other complications had no significant difference between the two groups (P > 0.05). No relationship was found between the neonatal outcomes and the paternal HBV vertical transmission (P > 0.05). HBV DNA load in the serum of HBsAg-positive father, and the paternal first class family history of HBV are risk factors of paternal HBV vertical transmission. When the serum HBV DNA load in HBsAg-positive father is >/= 1.0 x 10(7) copy/ml, the possibility of paternal vertical transmission of HBV would increase.

The Treatment and Nursing Advance of Phototherapy for Neonatal Pathological Jaundice

目的 介绍光疗的研究进展,并解决光疗过程中存在的护理问题,以提高疗效,减少副作用.方法 参考国内外相关文献,对光源的发展及光疗的方法进行综合分析、比较、归纳.结果 光源的种类较多,方法多样.光源由传统的日光、冷白光、日光灯、蓝光灯、卤灯发展到近几年推出的绿光、蓝光发光二极管等;方法有双面蓝光箱、单面蓝光治疗仪、光纤毯、蓝光毯、蓝光床、蓝光发光二极管等.讨论 临床上应严格掌握光疗指针,根据病情选择光疗方式.普遍认为双面蓝光箱比单面蓝光治疗仪效果好,蓝光箱比蓝光毯光照效果好,而蓝光加绿光效果最佳.为了提高疗效,减少副作用,光疗过程中要注意保护患儿眼睛及外生殖器;保持皮肤清洁、完整,防止感染;维持体温的恒定;维持水、电解质平衡等。