RESUMO
OBJECTIVES: Clinical practice guidelines have recognized "Asian" and "East Asian" as risk factors for newborn jaundice and readmission. We sought to identify more detailed and specific, parent-identified races or ethnicities associated with jaundice readmission. METHODS: We conducted a case control study of 653 newborn infants born (2014-2016) at a West-Coast, urban hospital to examine specific parent-described races or ethnicities that are associated with newborn hospital readmissions for hyperbilirubinemia. Parent-reported race or ethnicity was abstracted from the California Newborn Screening Test. RESULTS: Our sample included 105 infants readmitted for jaundice (cases) and 548 infants as controls. In the full cohort, 66 infants (10.1%) were Coombs positive, 39 infants (6.0%) were born before 37 weeks' gestational age, and 405 infants (62.0%) were born to first-time mothers. The parents described the 653 infants using 45 unique races and ethnicities. In a multivariable model that controlled for Coombs positivity, gestational age <37 weeks, and primiparity, infants described as "Far East Asian" (odds ratio [OR] = 3.17; 95% confidence interval [CI] = 1.94-5.18) or "Southeast Asian" (OR = 3.17; 95% CI = 1.66-6.08) had increased risk for jaundice readmission. Infants described as Southeast Asian (eg, Laotian, Cambodian, Indonesian, Vietnamese, and Filipino) and Far East Asian (eg, Chinese, Korean, Taiwanese, Japanese, and Mongolian) had an increased risk of readmission. Finally, we did not find an association between South Asian (OR = 0.79; 95% CI = 0.33-1.92) race or ethnicity and risk of jaundice readmission. CONCLUSIONS: In this study, we help clarify and move beyond the term "Asian" as a risk factor for readmission due to hyperbilirubinemia.
Assuntos
Povo Asiático , Hiperbilirrubinemia/etnologia , Hiperbilirrubinemia/epidemiologia , Icterícia Neonatal/etnologia , Icterícia Neonatal/epidemiologia , Triagem Neonatal , Alta do Paciente/estatística & dados numéricos , Readmissão do Paciente/estatística & dados numéricos , California/epidemiologia , Estudos de Casos e Controles , Feminino , Humanos , Recém-Nascido , MasculinoAssuntos
Negro ou Afro-Americano/história , Deficiência de Glucosefosfato Desidrogenase/história , Hiperbilirrubinemia/história , Doenças do Prematuro/história , Deficiência de Glucosefosfato Desidrogenase/complicações , Deficiência de Glucosefosfato Desidrogenase/etnologia , História do Século XX , Humanos , Hiperbilirrubinemia/etnologia , Hiperbilirrubinemia/etiologia , Recém-Nascido , Recém-Nascido Prematuro , Doenças do Prematuro/etnologia , Doenças do Prematuro/etiologia , Masculino , Fatores de Risco , Estados Unidos/epidemiologiaRESUMO
Bilirubin concentrations have been recently reported to be negatively associated with type 2 diabetes mellitus. We examined the association between bilirubin concentrations and gestational diabetes mellitus. In a prospective cohort study, 2969 pregnant women were recruited prior to 16 weeks of gestation and were followed up until delivery. The value of bilirubin was tested and oral glucose tolerance test was conducted to screen gestational diabetes mellitus. The relationship between serum bilirubin concentration and gestational weeks was studied by two-piecewise linear regression. A subsample of 1135 participants with serum bilirubin test during 16-18 weeks gestation was conducted to research the association between serum bilirubin levels and risk of gestational diabetes mellitus by logistic regression. Gestational diabetes mellitus developed in 8.5 % of the participants (223 of 2969). Two-piecewise linear regression analyses demonstrated that the levels of bilirubin decreased with gestational week up to the turning point 23 and after that point, levels of bilirubin were increased slightly. In multiple logistic regression analysis, the relative risk of developing gestational diabetes mellitus was lower in the highest tertile of direct bilirubin than that in the lowest tertile (RR 0.60; 95 % CI, 0.35-0.89). The results suggested that women with higher serum direct bilirubin levels during the second trimester of pregnancy have lower risk for development of gestational diabetes mellitus.
Assuntos
Bilirrubina/sangue , Diabetes Gestacional/epidemiologia , Transição Epidemiológica , Hiperbilirrubinemia/diagnóstico , Complicações na Gravidez/diagnóstico , Adulto , Povo Asiático , Biomarcadores/sangue , China/epidemiologia , Estudos de Coortes , Fatores de Confusão Epidemiológicos , Diabetes Gestacional/etnologia , Diabetes Gestacional/etiologia , Diabetes Gestacional/prevenção & controle , Feminino , Seguimentos , Teste de Tolerância a Glucose , Humanos , Hiperbilirrubinemia/sangue , Hiperbilirrubinemia/etnologia , Hiperbilirrubinemia/fisiopatologia , Incidência , Testes para Triagem do Soro Materno , Gravidez , Complicações na Gravidez/sangue , Complicações na Gravidez/etnologia , Complicações na Gravidez/fisiopatologia , Segundo Trimestre da Gravidez , Estudos ProspectivosRESUMO
ABO hemolytic disease of the newborn occurs almost exclusively in infants of blood group A and B who are born to group O mothers. Positive Direct Antiglobulin Test (DAT) can identify those infants who are at risk of developing the ABO hemolytic disease. Earlier studies have suggested that BO incompatibility is associated with a positive DAT in black infants. In this study we sought to determine whether ABO incompatibility type could be associated with a higher rate of DAT positivity or clinical hemolytic disease. We reviewed the electronic medical records of all ABO-incompatible births over a 2-year period. There were 1537 ABO-incompatible births during the study period. DAT was more commonly positive among BO incompatible (21.5% in BO vs. 14.8% in AO, P=0.001) and black (18.8% in blacks vs. 10.8% in nonblacks, P=0.003) infants. DAT positivity was significantly associated with both severe hyperbilirubinemia (P=0.028) and hemolytic anemia (P<0.001). BO incompatibility was significantly associated with hemolytic anemia, but not severe hyperbilirubinemia, in the infants tested.
Assuntos
Sistema ABO de Grupos Sanguíneos/imunologia , População Negra/genética , Incompatibilidade de Grupos Sanguíneos/imunologia , Teste de Coombs , Eritroblastose Fetal/sangue , Sangue Fetal/imunologia , Imunidade Materno-Adquirida , Sistema ABO de Grupos Sanguíneos/genética , Adulto , Anemia Hemolítica Congênita/sangue , Anemia Hemolítica Congênita/etnologia , Anemia Hemolítica Congênita/genética , Incompatibilidade de Grupos Sanguíneos/etnologia , Eritroblastose Fetal/etnologia , Eritroblastose Fetal/genética , Feminino , Humanos , Hiperbilirrubinemia/sangue , Hiperbilirrubinemia/etnologia , Hiperbilirrubinemia/genética , Recém-Nascido , Isoanticorpos/imunologia , Masculino , Gravidez , Complicações na Gravidez/imunologia , Estudos RetrospectivosRESUMO
PURPOSE: To examine whether maternal asthma contributes to racial/ethnic differences in obstetrical and neonatal complications. METHODS: Data on white (n = 110,603), black (n = 50,284), and Hispanic (n = 38,831) singleton deliveries came from the Consortium on Safe Labor. Multilevel logistic regression models, with an interaction term for asthma and race/ethnicity, estimated within-group adjusted odds ratios (aORs) for gestational diabetes, gestational hypertension, pre-eclampsia, placental abruption, premature rupture of membranes, preterm delivery, maternal hemorrhage, neonatal intensive care unit admissions, small for gestational age, apnea, respiratory distress syndrome, transient tachypnea of the newborn, anemia, and hyperbilirubinemia after adjustment for clinical and demographic confounders. Nonasthmatics of the same racial/ethnic group were the reference group. RESULTS: Compared with nonasthmatics, white asthmatics had increased odds of pre-eclampsia (aOR, 1.28; 95% confidence interval [CI], 1.15-1.43) and maternal hemorrhage (aOR, 1.14; 95% CI, 1.04-1.23). White and Hispanic infants were more likely to have neonatal intensive care unit admissions (aOR, 1.19; 95% CI, 1.11-1.28; aOR, 1.16; 95% CI, 1.02-1.32, respectively) and be small for gestational age (aOR, 1.11; 95% CI, 1.02-1.20; aOR, 1.26; 95% CI, 1.10-1.44, respectively), and Hispanic infants were more likely to have apnea (aOR, 1.32; 95% CI, 1.02-1.69). CONCLUSIONS: Maternal asthma did not affect most obstetrical and neonatal complication risks within racial/ethnic groups. Despite their increased risk for both asthma and many complications, our findings for black women were null. Asthma did not contribute to racial/ethnic disparities in complications.
Assuntos
Asma/etnologia , Disparidades nos Níveis de Saúde , Doenças do Recém-Nascido/etnologia , Complicações na Gravidez/etnologia , Descolamento Prematuro da Placenta/etnologia , Adulto , Apneia/etnologia , Asma/complicações , População Negra , Parto Obstétrico , Diabetes Gestacional/etnologia , Etnicidade , Feminino , Ruptura Prematura de Membranas Fetais/etnologia , Hispânico ou Latino , Humanos , Hiperbilirrubinemia/etnologia , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Hemorragia Pós-Parto/etnologia , Pré-Eclâmpsia/etnologia , Gravidez , Nascimento Prematuro/etnologia , Síndrome do Desconforto Respiratório do Recém-Nascido/etnologia , Estudos Retrospectivos , Taquipneia/etnologia , Estados Unidos , População Branca , Adulto JovemRESUMO
PURPOSE: The objective of this study was to compare two salient neonatal outcomes-respiratory disorders and hyperbilirubinemia-between late-preterm (34-36 weeks) and full-term (37-41 weeks) singleton infants both at the population level and within families. METHODS: Analyses were based on natality data on all births in the state of New Jersey from 1996 to 2006 linked to newborn hospital discharge records. For population-level models, logistic regression analyses were conducted to estimate unadjusted and adjusted differences in outcomes by gestational age. For within-family analyses, unadjusted and adjusted logistic fixed-effects models were estimated with the latter including factors that differed across births to the same mother. RESULTS: Late-preterm birth increased the odds of a neonatal respiratory condition by more than fourfold (odds ratio, 4.08-4.53) and of neonatal hyperbilirubinemia by more than fivefold (odds ratio, 5.11-5.93) even when comparing births to the same mother and controlling for demographic and economic, behavioral, and obstetric factors that may have changed across pregnancies. CONCLUSIONS: Based on population-level and within-family models, this study provides the strongest evidence to date that late-preterm birth is an important risk factor for adverse neonatal outcomes that other studies have found are associated with cognitive and behavioral disorders in childhood.
Assuntos
Idade Gestacional , Hiperbilirrubinemia/epidemiologia , Recém-Nascido Prematuro , Nascimento Prematuro/epidemiologia , Síndrome do Desconforto Respiratório do Recém-Nascido/epidemiologia , Adulto , Feminino , Humanos , Hiperbilirrubinemia/etnologia , Recém-Nascido , Morbidade , New Jersey/epidemiologia , Nascimento Prematuro/etnologia , Síndrome do Desconforto Respiratório do Recém-Nascido/etnologia , Estudos Retrospectivos , Fatores de Risco , Fatores SocioeconômicosRESUMO
Nilotinib potently inhibits human uridine diphosphate-glucuronosyltransferase (UGT1A1) activity, causing hyperbilirubinemia. We investigated the influence of UGT1A1 polymorphisms and nilotinib plasma trough concentrations (C0) on nilotinib-induced hyperbilirubinemia in 34 Japanese patients with chronic myeloid leukemia (CML). The proportion of patients with hyperbilirubinemia was significantly higher among patients with the UGT1A1*6/*6 and *6/*28 genotypes (poor metabolizers) than among those with other genotypes (p = 0.004). The median time to elevation of bilirubin levels in UGT1A1 poor metabolizers was 2.0 weeks (hazard ratio, 6.11). The median time to reduction in nilotinib dose in UGT1A1 poor metabolizers was 4.0 weeks (hazard ratio, 7.52; p = 0.002). Consequently, in the maintenance phase 3 months following the initiation of nilotinib therapy, the median daily dose and C0 of nilotinib were 350 mg/day and 372 ng/mL, respectively, in UGT1A1 poor metabolizers, and 600 mg/day and 804 ng/mL, respectively, in the other patients. Patients at increased hyperbilirubinemia risk could be identified by prospective UGT1A1 genotyping prior to nilotinib therapy. To avoid an interruption of CML treatment due to nilotinib-induced hyperbilirubinemia, it may be beneficial to reduce the initial nilotinib dose to 300-400 mg/day for UGT1A1 poor metabolizers.
Assuntos
Antineoplásicos/efeitos adversos , Povo Asiático/genética , Glucuronosiltransferase/antagonistas & inibidores , Glucuronosiltransferase/genética , Hiperbilirrubinemia/induzido quimicamente , Hiperbilirrubinemia/enzimologia , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Inibidores de Proteínas Quinases/efeitos adversos , Pirimidinas/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/administração & dosagem , Antineoplásicos/sangue , Antineoplásicos/farmacocinética , Bilirrubina/sangue , Biomarcadores/sangue , Cálculos da Dosagem de Medicamento , Feminino , Predisposição Genética para Doença , Humanos , Hiperbilirrubinemia/sangue , Hiperbilirrubinemia/etnologia , Japão/epidemiologia , Leucemia Mielogênica Crônica BCR-ABL Positiva/enzimologia , Leucemia Mielogênica Crônica BCR-ABL Positiva/etnologia , Masculino , Pessoa de Meia-Idade , Farmacogenética , Fenótipo , Inibidores de Proteínas Quinases/administração & dosagem , Inibidores de Proteínas Quinases/sangue , Inibidores de Proteínas Quinases/farmacocinética , Pirimidinas/administração & dosagem , Pirimidinas/sangue , Pirimidinas/farmacocinética , Medição de Risco , Fatores de RiscoRESUMO
Although black race is considered protective against hyperbilirubinemia, black infants appear at increased risk of kernicterus. We found that although black infants have a lower risk of developing total serum bilirubin levels ≥ 20 mg/dL than white infants, they appear at greater risk of developing levels ≥ 30 mg/dL.
Assuntos
Bilirrubina/sangue , Hiperbilirrubinemia/complicações , Hiperbilirrubinemia/etnologia , Icterícia Neonatal/sangue , População Negra , Humanos , Lactente , Recém-Nascido , Icterícia Neonatal/complicações , Fatores de RiscoRESUMO
OBJECTIVE: To compare the characteristics of jaundice and hyperbilirubinemia in the newborn population of both immigrant and Italian mothers. METHODS: The authors studied a group of 1,680 infants born at "A. Gemelli" hospital during 1 y. All were with appropriate weight for gestational age, weighting more than 2,500 g, born to low-risk pregnancy. Maternal ethnicity, clinically evident jaundice (that is total serum bilirubin (TSB) > 7 mg/dL), hyperbilirubinemia (TSB > 12 mg/dL), the duration of hospital stay and their need of phototherapy were evaluated. RESULTS: In infants born to Asian mothers, hyperbilirubinemia was significantly more frequent (48.8 % vs. 26.5 %, p = 0.003) and they reached mean TSB peak significantly later (86.5 ± 38.5 vs. 74.5 ± 20.6 h, P = 0.0001) compared with Italian infants. The average length of hospitalization of infants of Asian and Latin American mothers is significantly longer compared to Italian newborns (4.5 ± 1.9 vs. 3.6 ± 1.1, p <0.0001 and 4.2 ± 1.6 vs. 3.6 ± 1.1, p = 0.0004). With regard to the use of phototherapy, and to its duration, there are no significant differences between the populations studied. CONCLUSIONS: Having studied all infants at low risk, the greater length of hospitalization is due to later peak and the higher frequency of jaundice in newborns of immigrant mother, especially in Asia. Therefore, as it happens to the Italian newborns, it would be desirable to build forecasting nomograms in these populations, to reduce the length of hospitalization and facilitate protected discharge.
Assuntos
Bilirrubina/sangue , Emigrantes e Imigrantes/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Hiperbilirrubinemia/etnologia , Icterícia/etnologia , Adulto , Sudeste Asiático/epidemiologia , Feminino , Humanos , Recém-Nascido , Itália/epidemiologia , Masculino , Gravidez , Estudos ProspectivosRESUMO
BACKGROUND: Although glucose-6-phosphate dehydrogenase (G-6-PD) deficiency is prevalent in African Americans, their risk of associated neonatal hyperbilirubinemia has not been prospectively studied. OBJECTIVE: To compare hemolysis and the risk of hyperbilirubinemia among African American, G-6-PD-deficient neonates (study group) and G-6-PD-normal control subjects. METHODS: Consecutive, healthy, term and near-term, male neonates born to African American mothers comprised the patient cohort. G-6-PD testing was performed with umbilical cord blood samples. Routine management included measurement of the end tidal carbon monoxide level corrected for ambient carbon monoxide level (ETCOc) within 4 hours after delivery (assessment of hemolysis), > or =1 predischarge bilirubin determination, and additional bilirubin testing as clinically indicated. Indications for phototherapy were identical for study patients and control subjects. Neonates were monitored for the first 1 week of life. ETCOc results, the incidence of hyperbilirubinemia (defined as a transcutaneous or plasma total bilirubin concentration of > or =95th percentile for the hour of life), and the need for phototherapy were compared between the G-6-PD-deficient and G-6-PD-normal groups. RESULTS: Five hundred male patients were enrolled, of whom 64 (12.8%) were G-6-PD-deficient. ETCOc values (median and interquartile range) were higher among G-6-PD-deficient neonates than among control neonates (2.4 ppm [2.0-2.9 ppm] vs 2.1 ppm [1.7-2.5 ppm]). More G-6-PD-deficient neonates developed hyperbilirubinemia than did control subjects (14 of 64, 21.9%, vs 29 of 436, 6.7%; relative risk: 3.27; 95% confidence interval: 1.83-5.86), whereas 13 (20.3%) met the criteria for phototherapy, compared with 25 control subjects (5.7%) (relative risk: 3.53; 95% confidence interval: 1.91-6.56). No cases of kernicterus were observed. CONCLUSIONS: Within the African American neonatal population, there is a subgroup of G-6-PD-deficient infants with elevated rates of hemolysis, a higher incidence of hyperbilirubinemia, and a greater requirement for phototherapy, compared with G-6-PD-normal control subjects. These newborns should be monitored vigilantly for the development of hyperbilirubinemia.
Assuntos
Deficiência de Glucosefosfato Desidrogenase/etnologia , Hiperbilirrubinemia/etnologia , Bilirrubina/sangue , População Negra , Monóxido de Carbono/análise , Glucosefosfato Desidrogenase/metabolismo , Deficiência de Glucosefosfato Desidrogenase/complicações , Deficiência de Glucosefosfato Desidrogenase/fisiopatologia , Hemólise , Humanos , Hiperbilirrubinemia/etiologia , Hiperbilirrubinemia/terapia , Recém-Nascido , Masculino , Análise Multivariada , Fototerapia , Análise de Regressão , RiscoRESUMO
OBJECTIVE: The objective of this study was to determine whether transcutaneous bilirubin (TcB) measurements correlate with serum total bilirubin (STB) levels in indigenous, darkly pigmented African newborns with varying degrees of skin pigmentation, some of which had developed kernicterus. METHODS: Jaundiced infants who were < or =2 weeks of age and admitted to Baptist Medical Center-Eku (Eku; n = 29) and Jos University Teaching Hospital (Jos; n = 98) in Nigeria were studied. TcB measurements using the BiliChek were made simultaneously with blood sampling for STB measurements by spectrophotometry before phototherapy. RESULTS: Using linear regression analysis, we found that measurements of TcB correlated well with those of STB with r values of.90 and.88 for Eku and Jos, respectively. Mean bias and imprecision of TcB measurements as compared with STB measurements for the total population was 0.5 +/- 7.6 mg/dL using the method of Bland and Altman. At STB > or 12 mg/dL, correlation (r =.84) and bias and imprecision (-1.2 +/- 8.6 mg/dL) of measurements were only slightly poorer. Furthermore, when infants were grouped by degree of skin pigmentation, correlations of TcB and STB measurements remained strong. CONCLUSIONS: From these results, we can conclude that TcB measurements are a useful and reliable index for estimating STB levels in pigmented neonates, including those with hyperbilirubinemia and kernicterus. In the absence of reliable STB measurements, the relatively simple and noninvasive TcB measurements can be an important adjunct in directing phototherapy and exchange transfusions, thereby preventing bilirubin-induced morbidity and mortality in low-technology clinical environments.
Assuntos
Bilirrubina/análise , Hiperbilirrubinemia/diagnóstico , Viés , Bilirrubina/sangue , População Negra , Feminino , Humanos , Hiperbilirrubinemia/etnologia , Recém-Nascido , Kernicterus/diagnóstico , Modelos Lineares , Masculino , Triagem Neonatal/instrumentação , Nigéria , Pele , Pigmentação da PeleRESUMO
AIMS: A multisite study of term and near term infants readmitted in the first two weeks of life to 9 New York City area hospitals in 1995 was conducted to evaluate factors related to readmission, including length of newborn stay. RESULTS: Of the 30,884 infants born at the 9 study hospitals 391 newborns were readmitted. The major admission diagnoses were infection, 40.7%, hyperbilirubinemia, 39.1%, and feeding and/or gastrointestinal problems, 10.5%. In the first week, 65.1% of readmissions were for hyperbilirubinemia and 19.1% were for infection or suspected sepsis. In the second week, 67.8% of readmissions were for infection and 7.6% were for hyperbilirubinemia. Hyperbilirubinemia was the most frequent diagnosis for White and Asian infants, while infection was most frequent for African-American and Hispanic infants. Age at readmission was younger and the interval from discharge was shorter for infants with hyperbilirubinemia. Abnormalities which should have precluded early discharge included feeding difficulties, cyanotic congenital heart defects, hemolytic disease of the newborn, early jaundice or early high bilirubin levels. CONCLUSION: Attention to identification of infants at risk and programs such as lactation counseling and universal screening for bilirubin (with appropriate interpretation) prior to discharge could have reduced the necessity for readmission regardless of the newborn length of stay.
Assuntos
Hiperbilirrubinemia/fisiopatologia , Recém-Nascido , Alta do Paciente/estatística & dados numéricos , Readmissão do Paciente/estatística & dados numéricos , Adolescente , Adulto , Negro ou Afro-Americano , Bilirrubina/sangue , Alimentação com Mamadeira , Aleitamento Materno , Estudos de Coortes , Anormalidades Congênitas , Feminino , Idade Gestacional , Hispânico ou Latino , Humanos , Hiperbilirrubinemia/etnologia , Hiperbilirrubinemia/etiologia , Infecções/complicações , Infecções/etnologia , Infecções/fisiopatologia , Icterícia Neonatal/fisiopatologia , Masculino , New York , Estudos Retrospectivos , Fatores de Risco , População BrancaRESUMO
A review was conducted to determine the trends in exchange transfusion (ET) of newborn infants at the Yodogawa Christian Hospital during the past 18 years. At that hospital in 1957, the first ET was performed on a term infant with severe hemolytic jaundice caused by rhesus factor (Rh) incompatibility. By 1989, ET had been performed in more than 1400 newborn infants. These cases of newborns who had had ET were retrospectively reviewed, with a focus on every 3 year period from 1974 to 1992. The total number of infants requiring ET noticeably decreased from 68 cases (14.0% of total admissions) in 1974 to 19 cases (6.1% of total admissions) in 1992. (chi 2, P < 0.001) There were three major significant changes in ET during those years. The first was a change in the subjects for ET. The incidence of ET for term infants showed a marked decrease, while the incidence of ET for preterm infants, especially for very low birthweight (VLBW) infants (< 1500 g), noticeably increased. The second was a change in indications for ET. There was a marked decrease in the need for ET as a result of hyperbilirubinemia, while the incidence of ET because of other etiologies, such as septicemia and/or disseminated intravascular coagulopathy, noticeably increased. The third was a change in the technical methods of ET. Now at the Yodogawa Christian Hospital, 100% of the infants are given ET with an automated peripheral two-site method, instead of the Diamond method. Although ET might still be a useful treatment for severe hyperbilirubinemia and other acute problems, the total number of ET noticeably decreased in accord with a decrease in the number of severe hyperbilirubinemia in term newborns. On the other hand, the incidence of ET in preterm infants increased relatively, accompanied by an increase in the survival of VLBW infants. The automated two-site method is the preferred technique for ET at the Yodogawa Christian Hospital, rather than the Diamond method. Further changes in ET might occur in accord with new alternative measures in future.
Assuntos
Transfusão Total/estatística & dados numéricos , Cristianismo , Transfusão Total/tendências , Hospitais Religiosos , Humanos , Hiperbilirrubinemia/etnologia , Hiperbilirrubinemia/terapia , Recém-Nascido , Recém-Nascido Prematuro , Doenças do Prematuro/etnologia , Doenças do Prematuro/terapia , JapãoRESUMO
Cord blood from 8,975 babies delivered in Hospital Sultanah Aminah Johor Bahru over a period of eight months (1st August 1985 to 31st March 1986) were screened for G6PD deficiency. The overall incidence was 4.5% in Chinese, 3.5% in Malays and 1.5% in Indian babies. One hundred of these babies were observed in the nursery for seven days and their daily serum bilirubin recorded. The serum bilirubin peaked at 96 hours to a value of 12mg%. None of the babies in the nursery developed a serum bilirubin level of more than 15mg%. Six of the babies with G6PD deficiency that were sent home were readmitted with hyperbilirubinaemia that needed exchange transfusion.