Clinico-etiological profile of neonates admitted with jaundice in a tertiary care NICU of Central India

Authors

  • Ashish Kalraiya Department of Pediatrics, People’s College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India
  • Pankaj Gyanani Department of Pediatrics, People’s College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India
  • Shiv Ram Krishna Dubey Department of Pediatrics, People’s College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India
  • Vijaya Beohar Department of Pediatrics, People’s College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India
  • Pramila Verma Department of Pediatrics, Chirayu Medical College and Research Centre, Bhopal, Madhya Pradesh, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20181540

Keywords:

Hyperbilirubinemia, Jaundice, Neonates, NICU

Abstract

Background: Hyperbilirubinemia is a common problem and, in most cases, a benign problem in neonates. Jaundice is observed during the 1st week of life in approximately 60% of term infants and 80% of preterm infants.

Methods: In present study, total 187 newborns were enrolled prospectively over one and half year of study period from November 2015 to April 2017. Detailed patient information was taken at the time of admission in NICU. In this study all the newborns with age less than 28 days were included who had clinical jaundice, ascertained by Kramer’s criteria and confirmed by biochemical methods. The investigations done were Serum bilirubin (total, direct and indirect) complete blood picture, reticulocyte count, G6-PD estimation (qualitative), Coombs' test, peripheral smear examination, blood group (ABO,Rh) of the mother and baby, CBC,CRP, thyroid function test.

Results: Total 187 newborns were enrolled for study. Maximum number of the babies have a pathological jaundice 108 (57.7%) whereas 79 (42.24%) were found to have exaggerated physiological jaundice. The commonest causes of pathological jaundice were found to be septicemia 63 (33.68%) followed by ABO incompatibility 25 (13.36%). Most of the babies had onset of jaundice between 24-72 hours (86.6%).

Conclusions: Health care providers working with neonates play a key role in identifying and assessing neonates at risk for pathologic jaundice. Parents counseling is required for bringing their babies early to healthcare centre preventing acute bilirubin encephalopathy and subsequent kernicterus.

References

Kliegman RM, Behrman RE, Jensen HB, Stranton B. Neonates for early diagnosis and prevention of adverse consequence of neonatal hyperbilirubinemia Nelson Textbook Pediatrics. Elsevier; 2012:603-12.

Brown AK, Damus K, Kim MH. Factors relating to readmission of term and near-term neonates in the first-two weeks of life. J Perinat Med 1999;27(4):263-75.

IAP-NNF guidelines 2006 on level II neonatal care. Jaundice in newborn; 2006;187-210. Available at: www.ijrr.com

Chib R, Bhandari B. Clinico-demographic profile of hyperbilirubinemia in neonates admitted to a tertiary care hospital. Int J Contemp Pediatr. 2016;3(2):328-33.

Bhutani VK. Evidence based issues regarding neonatal hyperbilirubinemia. Pediatr Rev. 2005;114:130-53.

Bajpai PC, Mishra PK, Agarwal M. An etiological study of neonatal hyperbilirbinemia. Indian J Pediatr. 1971;38:424-9.

Singhal PK, Singh M, Paul VK, Deorari AK, Ghorpade MG. Spectrum of neonatal hyperbilirubinemia: An analysis of 454 cases. Indian Pediatr. 1992;29:319-25.

Ali A, Tomar A. Etiological profile of neonatal hyperbilirubinaemia in the rural area of Rajasthan. Indian J Basic Applied Med Res. 2015;4(2):223-32.

Rasul CH, Hasan MA, Yasmin F. Outcome of neonatal hyperbilirubinemia in a tertiary care hospital in Bangladesh. Malaysian J Med Sci. 2010;17(2):40-4.

Jamir S, Ngangom AS. A study of neonatal hyperbilirubinemia in a tertiary care hospital in the north eastern region of India. Int J Cur Res Rev. 2016;8(20):26-9.

Bahl L, Sharma R, Sharma J. Etiology of neonatal jaundice at Shimla. Indian J Pediatr. 1994;31:1275-8.

Merchant RH, Merchant SM, Babar ST. A study of 75 cases of neonatal jaundice. Indian Pediatr. 1975;12:889-93.

Zabeen B, Nahar J, Nabi N, Baki A, Tayyeb S, Azad K, et al. Risk factors and outcome of neonatal jaundice in a tertiary hospital. Ibrahim Med Coll J. 2010;4(2):70-3.

Sgro M, Campbell D, Shah V. Incidence and causes of severe neonatal Hyperbilirubinemia in Canada. CMAJ. 2006;175(6):587-90.

Heydarian F, Majdi M. Severe neonatal hyperbilirubinemia; causes and contributing factors leading to exchange transfusion at Ghaem Hospital in Mashhad. Acta Medica Iranica. 2010;48(6):399-402.

Joshi BD, Dharan, Nepal HR, Mahato D. Bilirubinemia in term babies at B. P. Clinico-laboratory profile of neonatal hyper. JNHRC. 2004;(2):30-32.

Anand JS, Magotra ML. Neonatal jaundice: its incidence and etiology. Indian Paediatr. 1978;15:155-60.

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Published

2018-04-20

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Original Research Articles