Academic literature on the topic 'Ictere neonatal'

Background: Neonatal hyperbilirubinemia is one of the commonest problems in newborn. It can be due to different etiologies. Most often it is physiological jaundice. The main reasons for physiological jaundice is that in an infant the liver is not mature enough to handle the freely circulating bilirubin due to higher volume of short life erythrocytes in the circulation and low level of albumin. Early detection of neonatal jaundice is essential to prevent developing kernicterus as well as discharge the babies early. Albumin is synthesized by liver and helps in the transport of unconjugated bilirubin by binding to bilirubin it and thus making it nontoxic to the body. Low levels of albumin make bilirubin free and toxic to the body. Hence, this study was done to evaluate effectiveness of cord blood albumin as a predictor of neonatal Hyperbilirubinemia.Methods: 50 term healthy newborns were included in the study with the term babies of both genders from any mode of delivery, birth weight >2.5 kg, APGAR score more than 7 at 1st and 5th minutes of life and without Rh incapability. Cord blood albumin levels were measured. Blood test for bilirubin was done when required and baby was managed accordingly.Results: Out of the total 50 neonates enrolled, 7 belonged to group 1 (albumin <2.8 g/dl), 34 to group 2 (2.8-3.3 g/dl), and 9 to group 3 (>3.3 g/dl). Out of the total 7 neonates in group 1, 6 (85.71%) was icteric at 24-48 hours and 1 (14.29%) was icteric at >72 hours. All the 7 neonates developed Hyperbilirubinemia requiring phototherapy. 3 (42.86%) out the 7-neonate required phototherapy for more than 24 hours. Out of the total 34 neonates in group 2, 20 (58.82%) was icteric at >72 hours, 12 (35.29%) at 48-72 hours and 2 (5.88%) at 24-48 hours. Only 12 (35.29%) neonates had Hyperbilirubinemia requiring phototherapy. Out of the total 9 neonates in group 3, 1 was icteric at 48 - 72 hours and 8 was icteric at >72 hours. But only 2 had Hyperbilirubinemia requiring phototherapy.Conclusions: Cord blood albumin is an effective way to predict neonatal Hyperbilirubinemia in term healthy infants.

Hyperbilirubinemia is one of the most common clinical phenomena in neonatal patient. Etiology is generally physiological, only about 10% being pathological. It is important for clinicians to distinguish between physiological and pathological hyperbilirubinemia, because uncontrolled pathological conditions can cause severe complications of kern icterus, one ofthe causes of death in infants.This study was retrospective study by obtaining data of all neonatal patients with diagnosis of hyperbilirubinemia, who undergone hemoglobin and leukocyte count test. The data were classified into two groups: physiological and pathological hyperbilirubinemia. Statistical tests were performed to assess the association of hemoglobin levels and leukocytes count between the two groups. A total of 144 data were collected, 54 physiological and 90 pathological hyperbilirubinemia. In physiological hyperbilirubinemia, hemoglobin levels and leukocyte counts were found to be normal, whereas in pathological anemia and leukocytosis developed and the difference between the two groups was statistically significant (p<0,001). Anemia was found in neonates with pathological hyperbilirubinemia caused by RDN, LBW, sepsis, hemolytic, and hemorrhagic. Leukocytosis was found in pathological hyperbilirubinemia caused by sepsis.There was a significant difference between the incidence of anemia and leukocytosis in physiological and pathological hyperbilirubinemia. It can be concluded that routine blood tests can be used to distinguish whether hyperbilirubinemia experienced by neonatel patient is a physiological or pathological condition, so it can be one of the tests suggested when the neonate is hyperbilirubinemia.

BACKGROUND Hyperbilirubinemia is the most common cause of hospital readmission in neonates affecting about 60 % of term and 85 % of preterm neonates. Often, it is a benign condition but may result in neurological sequelae like bilirubin induced encephalopathy and kernicterus spectrum of disorders. We wanted to evaluate the foetal and maternal risk factors of hyperbilirubinemia and also identify the modifiable risk factors of it in neonates. METHODS An observational case - control study was carried out from July 2018 to July 2020. Neonates with hyperbilirubinemia levels in the range of phototherapy as described by the age and gestation by the American Academy of Paediatrics were taken as cases and neonates without hyperbilirubinemia were taken as controls. Detailed demographic-, prenatal-, perinatal-, family-history and physical-examination was undertaken for all the neonates included in the study and various risk factors were assessed such as the presence of maternal illness, intrauterine growth retardation (IUGR), premature rupture of membranes (PROM), prematurity, ABO and Rh incompatibility, previous history of phototherapy in siblings, breast feeding problems and birth asphyxia. RESULTS Multivariate logistic regression studies of data collected has shown a significant association between IUGR (P value 0.01), prematurity (P value 0.002), ABO incompatibility (P value 0.009), breast feeding problems (P value 0.001), birth asphyxia (P value 0.05) and presence of PROM (P value 0.05) with neonatal hyperbilirubinemia. CONCLUSIONS Early identification of neonatal hyperbilirubinemia and prompt intervention reduces the morbidity and mortality associated with this common condition. KEY WORDS Jaundice of Neonate, Neonatal Jaundice, Icterus Neonatorum

Objetivo: validar tecnologia educacional sobre fototerapia para orientar familiares de neonatos ictéricos. Método: estudo de desenvolvimento metodológico, realizado em 2012, com nove juízes especialistas, 11 enfermeiros assistenciais e 11 familiares, mediante aplicação de questionários submetidos à análise estatística. Foi realizado em uma maternidade pública estadual no município de Manaus, Brasil. Resultados: a tecnologia a ser validada foi do tipo álbum seriado, com dupla face, intitulado A luz que cura, a mão que cuida. O Índice de Validade de Conteúdo (IVC) foi de 79,7%. O Índice de Concordância (IC) na validação de aparência foi de 96,1% entre enfermeiros e 97,2% entre familiares. Conclusão:a tecnologia educacional mostrou-se válida quanto ao conteúdo e aparência, com potencial para orientar familiares de neonatos ictéricos por enfermeiros que atuam na área neonatal e maternidade.ABSTRACTObjective: to validate an educational technology on phototherapy designed to guide family members of icteric neonates. Method: a methodological study carried out in 2012 with 9 specialist, 11 nursing assistants and 11 family members, through the application of questionnaires later submitted to statistical analysis. The study was conducted in a state public maternity hospital in the city of Manaus, Brazil. Results: the technology that was to be validated was a double-sided flip chart called The light that heals, the hand that cares. The Content Validity Index was 79.7%. The Concordance Index for the validation of appearance was 96.1% among nurses and 97.2% among family members. Conclusion: the educational technology was validated for content and appearance and demonstrated potential for orientations of family members of icteric neonates conducted by nurses who work in the neonatal and maternity areas.RESUMENObjetivo: validar tecnología educativa sobre fototerapia para orientar a familiares de neonatos ictéricos. Método: estudio de desarrollo metodológico, realizado en 2012, con 9 jueces especialistas, 11 enfermeros asistenciales y 11 familiares, mediante aplicación de cuestionarios sometidos al análisis estadístico. Se realizó en una maternidad pública estadual en el municipio de Manaus, AM, Brasil. Resultados: la tecnología validada fue del tipo álbum seriado, con doble cara, titulado La luz que cura, la mano que cuida. El Índice de Validez de Contenido fue del 79,7%. El Índice de Concordancia en la validación de apariencia fue del 96,1% entre enfermeros y el 97,2% entre familiares. Conclusión: la tecnología educativa se mostró válida en cuanto al contenido y apariencia, con potencial para orientar a familiares de neonatos ictéricos por enfermeros que actúan en el área neonatal y maternidad.

Red blood cell glucose-6-phosphate dehydrogenase (G6PD) is a key regulatory enzyme with the major role of meeting the cellular need for reductive biosynthesis and maintenance of redox status. G6PD deficiency is a common inherited enzyme defect associated with severe neonatal hyperbilirubinaemia that can result in permanent neurologic damage or death. This study was aimed at estimating the level of G6PD activity among icteric neonates to assess its usefulness in the evaluation of icteric neonates in Jos. One hundred and fifty icteric neonates (92 males and 58 females) whose parents consented were consecutively enrolled as they presented at the Special Care Baby Units (SCBU) of the Jos University Teaching Hospital (JUTH), Bingham University Teaching Hospital (BhUTH), and the Plateau State Specialist Hospital (PSSH), Jos. These subjects had their G6PD activity levels assayed using the Pointe Quantitative Diagnostic Kit (USA) while other relevant clinical information was obtained using a questionnaire. G6PD activity of the icteric neonates ranged between 0.54 and 24.18 IU/gHb with a mean of 8.02 ± 4.87 IU/gHb. Sixty-one (40.7 %), comprising 45 males and 16 female neonates were G6PD deficient with mean G6PD activity of 3.79 ± 1.37 IU/gHb while eighty-nine (59.3%) were G6PD normal with a mean G6PD activity of 10.92 ± 4.24 IU/gHb. G6PD activity in icteric neonates in Jos varies widely with a relatively high proportion of these neonates being G6PD deficient. Determination of G6PD activity in icteric neonates should therefore form an important evaluation tool for identification and intervention in those with the deficiency.

Red blood cell glucose-6-phosphate dehydrogenase (G6PD) is a key regulatory enzyme with the major role of meeting the cellular need for reductive biosynthesis and maintenance of redox status. G6PD deficiency is a common inherited enzyme defect associated with severe neonatal hyperbilirubinaemia that can result in permanent neurologic damage or death. This study was aimed at estimating the level of G6PD activity among icteric neonates to assess its usefulness in the evaluation of icteric neonates in Jos. One hundred and fifty icteric neonates (92 males and 58 females) whose parents consented were consecutively enrolled as they presented at the Special Care Baby Units (SCBU) of the Jos University Teaching Hospital (JUTH), Bingham University Teaching Hospital (BhUTH), and the Plateau State Specialist Hospital (PSSH), Jos. These subjects had their G6PD activity levels assayed using the Pointe Quantitative Diagnostic Kit (USA) while other relevant clinical information was obtained using a questionnaire. G6PD activity of the icteric neonates ranged between 0.54 and 24.18 IU/gHb with a mean of 8.02 ± 4.87 IU/gHb. Sixty-one (40.7 %), comprising 45 males and 16 female neonates were G6PD deficient with mean G6PD activity of 3.79 ± 1.37 IU/gHb while eighty-nine (59.3%) were G6PD normal with a mean G6PD activity of 10.92 ± 4.24 IU/gHb. G6PD activity in icteric neonates in Jos varies widely with a relatively high proportion of these neonates being G6PD deficient. Determination of G6PD activity in icteric neonates should therefore form an important evaluation tool for identification and intervention in those with the deficiency.

Red blood cell glucose-6-phosphate dehydrogenase (G6PD) is a key regulatory enzyme with the major role of meeting the cellular need for reductive biosynthesis and maintenance of redox status. G6PD deficiency is a common inherited enzyme defect associated with severe neonatal hyperbilirubinaemia that can result in permanent neurologic damage or death. This study was aimed at estimating the level of G6PD activity among icteric neonates to assess its usefulness in the evaluation of icteric neonates in Jos. One hundred and fifty icteric neonates (92 males and 58 females) whose parents consented were consecutively enrolled as they presented at the Special Care Baby Units (SCBU) of the Jos University Teaching Hospital (JUTH), Bingham University Teaching Hospital (BhUTH), and the Plateau State Specialist Hospital (PSSH), Jos. These subjects had their G6PD activity levels assayed using the Pointe Quantitative Diagnostic Kit (USA) while other relevant clinical information was obtained using a questionnaire. G6PD activity of the icteric neonates ranged between 0.54 and 24.18 IU/gHb with a mean of 8.02 ± 4.87 IU/gHb. Sixty-one (40.7 %), comprising 45 males and 16 female neonates were G6PD deficient with mean G6PD activity of 3.79 ± 1.37 IU/gHb while eighty-nine (59.3%) were G6PD normal with a mean G6PD activity of 10.92 ± 4.24 IU/gHb. G6PD activity in icteric neonates in Jos varies widely with a relatively high proportion of these neonates being G6PD deficient. Determination of G6PD activity in icteric neonates should therefore form an important evaluation tool for identification and intervention in those with the deficiency.

Red blood cell glucose-6-phosphate dehydrogenase (G6PD) is a key regulatory enzyme with the major role of meeting the cellular need for reductive biosynthesis and maintenance of redox status. G6PD deficiency is a common inherited enzyme defect associated with severe neonatal hyperbilirubinaemia that can result in permanent neurologic damage or death. This study was aimed at estimating the level of G6PD activity among icteric neonates to assess its usefulness in the evaluation of icteric neonates in Jos. One hundred and fifty icteric neonates (92 males and 58 females) whose parents consented were consecutively enrolled as they presented at the Special Care Baby Units (SCBU) of the Jos University Teaching Hospital (JUTH), Bingham University Teaching Hospital (BhUTH), and the Plateau State Specialist Hospital (PSSH), Jos. These subjects had their G6PD activity levels assayed using the Pointe Quantitative Diagnostic Kit (USA) while other relevant clinical information was obtained using a questionnaire. G6PD activity of the icteric neonates ranged between 0.54 and 24.18 IU/gHb with a mean of 8.02 ± 4.87 IU/gHb. Sixty-one (40.7 %), comprising 45 males and 16 female neonates were G6PD deficient with mean G6PD activity of 3.79 ± 1.37 IU/gHb while eighty-nine (59.3%) were G6PD normal with a mean G6PD activity of 10.92 ± 4.24 IU/gHb. G6PD activity in icteric neonates in Jos varies widely with a relatively high proportion of these neonates being G6PD deficient. Determination of G6PD activity in icteric neonates should therefore form an important evaluation tool for identification and intervention in those with the deficiency.

Red blood cell glucose-6-phosphate dehydrogenase (G6PD) is a key regulatory enzyme with the major role of meeting the cellular need for reductive biosynthesis and maintenance of redox status. G6PD deficiency is a common inherited enzyme defect associated with severe neonatal hyperbilirubinaemia that can result in permanent neurologic damage or death. This study was aimed at estimating the level of G6PD activity among icteric neonates to assess its usefulness in the evaluation of icteric neonates in Jos. One hundred and fifty icteric neonates (92 males and 58 females) whose parents consented were consecutively enrolled as they presented at the Special Care Baby Units (SCBU) of the Jos University Teaching Hospital (JUTH), Bingham University Teaching Hospital (BhUTH), and the Plateau State Specialist Hospital (PSSH), Jos. These subjects had their G6PD activity levels assayed using the Pointe Quantitative Diagnostic Kit (USA) while other relevant clinical information was obtained using a questionnaire. G6PD activity of the icteric neonates ranged between 0.54 and 24.18 IU/gHb with a mean of 8.02 ± 4.87 IU/gHb. Sixty-one (40.7 %), comprising 45 males and 16 female neonates were G6PD deficient with mean G6PD activity of 3.79 ± 1.37 IU/gHb while eighty-nine (59.3%) were G6PD normal with a mean G6PD activity of 10.92 ± 4.24 IU/gHb. G6PD activity in icteric neonates in Jos varies widely with a relatively high proportion of these neonates being G6PD deficient. Determination of G6PD activity in icteric neonates should therefore form an important evaluation tool for identification and intervention in those with the deficiency.

Background In vitro haemolysis is a common occurrence in clinical laboratories and causes a spurious increase in potassium. In the past, haemolysis was sought by visual inspection but is now commonly detected by automated measurement of the haemolytic index (HI). This study compared detection of haemolysis in adult and neonatal samples by inspection and measurement of HI and verified that a single equation is appropriate to correct for the increase in potassium in both haemolysed samples. Methods Laboratory staff inspected samples for haemolysis and their observations were compared with the measured HI. The potassium concentrations and haemolytic indices of 613 adult and 523 neonatal samples were correlated to derive equations to compensate for the increase in potassium with increase in HI. These were found not to differ significantly and a single equation for use in both populations was derived. Results The presence of icterus was found to decrease ability to detect haemolysis on inspection. The mean (95% confidence limits) potassium increase per unit HI was 0.0094 mmol/L (0.0078–0.0103 mmol/L) for adults and 0.0108 mmol/L (0.0094–0.0121 mmol/L) for neonates. The equation developed to compensate for potassium release in haemolysed samples was: adjusted potassium = measured potassium − (HI in μmol/L × 0.01). Conclusion The use of HI rather than visual inspection is particularly recommended in neonates whose serum tends to be icteric. It can be used in the same correction equation as in adults to compensate for potassium released due to haemolysis and facilitate reporting a qualitative comment to assist in immediate clinical management.

Introduction : La variabilité du rythme cardiaque est étudiée à partir des variations de durée des cycles cardiaques (intervalle R-R de l’électrocardiogramme). Ces variations peuvent être analysées par des méthodes linéaires (temporelles et fréquentielles) et non linéaires (théorie de l’information ou des fractales) de quantifications mathématiques et statistiques qui donnent des informations innovantes sur les signaux analysés. L’application de ces méthodes d’étude en néonatologie a démontré un intérêt pour le diagnostique précoce de l’infection néonatale tardive du prématuré mais n’avait pas été étudié dans l’infection néonatale précoce du nouveau-né à terme, dans le contexte des évènements cardio-respiratoires suivant la primo-vaccination des prématurés ou pour évaluer un effet neurologique de l’hyperbilirubinémie dans l’ictère néonatal. Notre hypothèse dans ce travail était qu’il était possible de : (i) caractériser la variabilité du rythme cardiaque en cas d’infection materno fœtale ou de méningite néonatale, (ii) mettre en évidence des facteurs prédisposant à la survenue d’évènements cardio-respiratoires post-vaccinaux, (iii) Identifier un éventuel retentissement neurologique de l’ictère néonatal par étude de la variabilité du rythme cardiaque
The heart rate variability measures permitted to evaluate equilibrium state and perturbation in the regulation of cardio-vascular system. These tools, based on heart rate variability analysis, helped to recognize associated disease state as early onset neonatal sepsis and non-infectious inflammatory response induced to immunization. An increase in global variability (SD), long term variability (SD, LF) and low approximated entropy (ApEn) were observed in the proven-sepsis full term infants. Importance of decrease in ApEn was correlated to the severity of sepsis assessed by blood markers. These suggest an association of sepsis with uncoordinated sympatho-vagal coactivation together with loss of adaptability. In premature infants, the risk of increase in cardio-respiratory events after the first immunization was associated with a specific pre-immunization profile: sympathetic predominance in heart rate control (high LF/HF ratio), abnormal oversimplification of heart rate variability and persistence rhythm control immaturity. Increased ApEn after immunization reflects a marginal result from adaptability of the heart rate to environmental changes without possibility to reserve in case of severe infection

In hierdie studie word die etiologiese verband tussen verstadigde neurologiese integrasie en latere leerproblematiek by kinders met klinies betekenisvolle neonatale bilirubienmetings ondersoek. Resente navorsing dui aan dat kinders met klinies betekenisvolle bilirubienmetings tydens die neonatale fase ‘n groter risiko loop om later verstadigde neurologiese integrasie te vertoon, veral weens die kwesbaarheid van die neonatale brein vir toksiene. Hierdie navorsingsresultate suggereer ‘n verband tussen klinies betekenisvolle neonatale bilirubienmetings en latere leerproblematiek, aangesien spesifieke breinareas wat deur neonatale bilirubien aangetas word ook vaardighede medieer wat belangrik is vir prestasie in sekere leerareas, te wete lees, skryf en reken. Neonatale fisiologiese geelsug is nie altyd met die blote oog sigbaar nie, en derhalwe word simptome soos oormatige slaperigheid en ingekorte behoefte aan voeding dikwels deur onervare moeders geïgnoreer, omdat die baba nie opmerklik “geel” is nie. Verder word neonatale fisiologiese geelsug nie altyd as sodanig gediagnoseer nie, weens verskeie faktore soos ontoereikende primêre gesondheidsorgdienste op die afgeleë platteland, tuisgeboortes en vroeë ontslag van moeders en babas uit klinieke en hospitale, veral gesien in die lig daarvan dat neonatale geelsug piekvlak tussen dag drie en dag sewe bereik. Bilirubienmeting is nie standaard prosedure by afgeleë klinieke nie, en waar ‘n rowwe skatting deur die klinieksuster op ‘n klinies betekenisvolle bilirubientelling dui, word moeders dan dikwels aangeraai om natuurlike fototerapie (sonlig) toe te pas. Verdermeer vind opvolgkonsultasies by ‘n klinieksuster dikwels eers plaas nadat die baba ongeveer een maand oud is, en voorligting aan die moeder rakende moontlike kwesbaarhede wat verband hou met klinies betekenisvolle neonatale bilirubienmetings is gebrekkig. Sodanige ouers kan dus heeltemal onbewus wees van die potensiële skade wat aangerig kan word aan die ontwikkelende brein, en intervensie vind gevolglik nie tydig plaas nie. Betekenisvolle duidinge wat uit hierdie navorsingsprojek mag voortvloei, kan derhalwe benut word ten einde spesifieke kwesbaarhede in kinders met klinies betekenisvolle neonatale bilirubienmetings tydig te kan identifiseer; en hoë-risiko leerders se moontlike latere leerproblematiek deur tydige intervensie tydens die voorskoolse jare te ondervang, voordat pobleme in die grondslagfase manifesteer. ‘n Empiriese ondersoek is uitgevoer waarby 37 deelnemers betrek is. Gebaseer op die resultate van die data-analise en interpretasie van die resultate word die hipotese aanvaar. Relevante aanbevelings met betrekking to praktykverbetering en verdere navorsing word gemaak. ENGLISH: With this study the etiological link between delayed neurological integration, high neonatal bilirubin measures and learning difficulties were investigated. Recent research findings suggest that children with high neonatal bilirubin measures are at a greater risk for delayed neurological integration later on, especially because of the susceptibility of the neonatal brain for toxins. The results of this research project suggest an etiological link between neonatal hyperbilirubinemia and learning difficulties at a later stage, since specific brain-areas which are affected by the bilirubin do mediate skills important for performance in certain learning areas, e.g. reading, writing and arithmetic. It is not always possible to notice neonatal physiological jaundice; hence, inexperienced mothers tend to ignore symptoms like sleepiness and lack of appetite, merely because their babies do not appear “yellowish”. Neonatal physiological jaundice is often misdiagnosed due to various factors like inadequate primary health care services in rural areas, home births and early discharge from hospitals - particularly in light of the fact that jaundice peaks between day three and day seven after birth. Measurement of neonatal bilirubin levels is not a standard procedure at rural clinics, and mothers are often advised to make use of natural phototherapy (sunlight) when the baby appears “yellowish”. Follow-up consultation often occurs when the baby is already one month old; hence mothers often receive inadequate information concerning neonatal hyperbilirubinemia. Parents might therefore be totally unaware of the potential vulnerability and harm to the developing brain, and intervention often does not take place. Significant indicators of this research project can be used to identify well in advance specific vulnerabilities in learners with neonatal hyperbilirubinemia, as well as potentially high-risk learners during the pre-school years, before such vulnerabilities escalate during the foundation phase. An empirical study with 37 participants was conducted. Based on the data analyses and interpretation of the results, the hypothesis was accepted. Relevant recommendations concerning best practice and further research were done.
Thesis (PhD)--University of Pretoria, 2008.
Educational Psychology
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