Clinico-demographic profile of hyperbilirubinemia in neonates admitted to a tertiary care hospital
DOI:
https://doi.org/10.18203/2349-3291.ijcp20161012Keywords:
Neonatal hyperbilirubinemia, Breast feeding, Breast milk, Physiologic jaundice, G6PDAbstract
Background: The purpose of this study was to find etiological and other associated factors of neonatal hyperbilirubinemia at a tertiary care hospital SGRRIM&HS Patel Nagar Dehradun Uttrakhand, India. Jaundice is a common problem in neonatology. Early recognition of the cause of jaundice is very important as delay in management may lead to serious complications or even death.
Methods: In present study, newborns with jaundice were evaluated during a 12 months period between January 2015 – December 2015. 195 newborns with jaundice were enrolled in the study. Data regarding demographic profile of new born, physical examination and laboratory investigations were gathered and analyzed to interpret the common etiologies giving rise to neonatal hyperbilirubinemia.
Results: Out of 195 cases of neonatal hyperbilirubinem, 40 cases belonged to physiological jaundice. Breast feeding jaundice-121 cases, breast milk jaundice-5 cases, jaundice due to prematurity-8 cases and pathological jaundice-21 cases (6 were of ABO incompatibility, 4 neonatal sepses, 4 Rh incompatibility, 4 G6PD deficiencies, 2 neonatal hypothyroidism and 1 congenital biliary atresia).
Conclusions: Present study concludes that breast feeding jaundice forms the bulk of cases of neonatal hyperbilirubinemia in our hospital, followed by physiological jaundice, jaundice of prematurity, ABO Incompatibility, breast milk jaundice, neonatal sepsis, Rh incompatibility, G6PD Deficiency, neonatal hypothyroidism and congenital biliary atresia.
References
Slusher TM, Angyo IA, Bode TF. Transcutaneous bilirubin measurements and serum total bilirubin levels in indigenous African infants. Pediatrics. 2004;113:1636-41.
Haque KM, Rahman M. An unusual case of ABO hemolytic disease of the new born. Bangladesh Med Res Counc. 2000;16:105-8.
Wang M, Hays T, Ambruso DR. Hemolytic diseases of the new born caused by a high titer antigroup B Ig G from a group A mother. Pediatr Blood cancer. 2005;45(6):861-2.
Ho NK. Neonatal jaundice in Asia. Baillieres Clin Haematol. 2002;5:131-42.
Ipek IO, Bozayakut A. Clinically significant neonatal hyperbilirubinemia: an analysis of 546 cases in Istanbul. J Trop Pediatr. 2008;54:212-3.
Olusanya BO, Akande AA, Emokpae A, Olowe SA. Infants with severe neonatal jaundice in Lagos, Nigeria. Trop Med Int Health. 2009;14(3):301-10.
Oladokun A, Otegbayo JA, Adeniyi AA. Maternal and fetal outcomes of jaundice in pregnancy in Ibadan, Nigeria. Niger. J Clin Pract. 2009;12(3):277-80.
Owa JA, Ogunlesi TA. Why we are still doing so many exchange blood transfusions for neonatal jaundice in Nigeria. World J Pediatr. 2009;5(1):51-5.
Sarici SU, Serdar MA, Korkmz A. Incidence, course and prediction of hyperbilirubinaemia in near term and term newborns. Paediatrics. 2004;113:775-80.
Madan A, James RM, Stevenson DK. Neonatal Hyperbilirubinemia. In: Taeusch HW, Ballard RA, Gleason CA. Avery’s diseases of the new born. 8th Ed. Elsevier Saunders. 2004;1226-56.
Laforgia N, Faienza MF, Rinaldi A. Neonatal hyperbilirubinemia and gilbert’s syndrome. J Perinat Med. 2002;30:166-9.
Mishra S, Agarwal R, Deorari AK. Jaundice in the new borns. Indian J Pediatr. 2008;75:157-63.
Maria FB, Cecilia MD. Neonatal Jaundice and breast feeding. Neo Reviews. 2007;8:282-8.
Weissman LE, Merenstein GB. Digirol M. The effect of early meconium evacuation on early onset hyperbilirubinemia. Am J Dis Child. 1988;137:666-8.
Broderson R, Herman LS. Intestinal absorption of unconjugated bilirubin: a possible contributing factor in neonatal jaundice. Lancet. 1963:1242.
Cynthia RH. Breast milk and breast feeding jaundice. Section 1 Diseases and Disorders. In: Lynne CG, Jeffrey K, Cynthia C. Mosby’s pediatric clinical advisor: instant diagnosis and treatment. 2nd Ed. Elsevier. 2002:200.
Kumal A, Ozkan H, Duman N. Breast milk jaundice correlates with high levels of EGF. Pediatr Res. 2009;66:218-21.
Watchko JF. Jaundice in low birth weight infants: pathobiology and outcome. Arch Dis Child Fetal Neonatal Ed. 2003;88:F455.
Consensus Statement on Management of Urinary Tract Infections. Indain Pediatrics. 2001;38:1106-15.
Najati N, Gharebaghi MM, Moratazavi F. Underlying etiologies of prolonged icterus in neonates. Pakistan J Biol Sci. 2010;13:711-4.
Bertini G, Dani C, Tronchin M. Is breast feeding really favoring early neonatal jaundice? Paediatrics. 2001;107:E41.
Prashant GD. Breast milk jaundice work up. E medicine. Medscape. com/article/973629. 2010.
Chan M. Neonatal Jaundice: In Stanfield P, Brueton M, Chan M, Parkin M. (Eds) Diseases of children in the tropics and subtropics (4th Edition) London. Edward Arnold. 1994:221-8.
Onyearugha CN, Onyire BN, Ugboma HA. Neonatal Jaundice: Prevalence and associated factors as seen in Federal Medical Center Abakaliki, Southeast Nigeria. J Clin Med Res. 2010;3:40-5.
Ahmed H, Yakubu AM, Hendrickse RG. Neonatal
jaundice in Zaria, Nigeria. West Afr. J Med. 1995;14(1):15-23.
Scott R, Aldangady N, Maalouf E. Neonatal hypopituitarism presenting with poor feeding, hypoglycaemia and prolonged unconjugated hyperbilirubinemia. J Matern Fetal Neonatal Med. 2004;16:131-3.
