P214 Hospitalised infants with jaundice in a secondary hospital (neonatal section), in thessaly (2015 – 2016). association with pathological-risk factors

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Abstract

Background

Sixty-five percent of newborns develop visible jaundice with a total serum bilirubin level higher than 6 mg/dl, during the first week of life. Causes of pathologic unconjugated hyperbilirubinemia are those, who engender hemolysis (ABO blood group and Rh incompatibility, G6PD deficiency), neonatal jaundice (NJ) as a result of neonatal infection and breast feeding associated jaundice. Treatment of indirect hyperbilirubinemia is phototherapy, exchange transfusion and antibiotics (if needed).

Aim

The recording/investigation of the frequency of cases of infants with NJ, hospitalised in Neonatal Department (ND) of our hospital (1/1/2015- 31/12/2016), the correlation with demographic and other factors (sex, gestational age (GA), birth weight (BW)) and the discussion of the results.

Method/Material

We were based on data, that were obtained by printed and online file of ’ASCLEPIUS’ (Hospital’s online patient file). There were included incidents of NJ, introduced in the Paediatric‘s clinic ND, of our hospital, came from the Hospital’s Obstetrical Clinic (O/C), Private O/C or from home. For the definition of the pathological values of jaundice, we used the tables of Greek Neonatal Society (2012).

Results

In total of 58 cases NJ {28 (2015), 30 (2016)}, the 40 were males (69%). They were categorised by the GA in near-term (35–37 w), full-term (>38w) and premature (<35w) newborns (51,5%, 45%, 3,5%, respectively). Comparing the BW,∼2/3 of newborns, who had jaundice were>3000 gr, while the percentage, based on the day of life, where hyperbilirubinemia occured, ranged as follows: 1 st day of life: 6.9%, 2nd day: 12%, 3rd day : 31%,>4 th day: 50%. In 1/3 of cases (∼36%) the cause of NJ was not clarified, while 24% was attributed to ABO group incompatibility and∼14% to perinatal infection (early-onset form: 87.5%). In the percentage of∼26% of NJ, were included more than one risk-factors. They treated with fototherapy (single and/or double), lasting 5–50 hours, good hydration and appropriate antibiotic treatment (in cases of infection). Two newborns were transferred to a Neonatal Intensive Care Unit, of the Tertiary Hospital in Thessaly, for further investigation/treatment.

Conclusions

NJ usually constitutes a normal clinical manifestation, but it needs monitoring, as it may, sometimes, be an indicator of some pathological conditions (NJ at the first day of life in most cases conceals neonatal infection). In contrast 48% of hyperbilirubinemia’s cases in the second and third day of life, participate as pathological agents, the above causes of hemolytic jaundice.

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