ABSTRACT
OBJECTIVE: To determine the prognostic value of indirect and direct hyperbilirubinemia in neonates with jaundice. METHODS: A cohort of 92 consecutive neonates reporting with hyperbilirubinemia to a tertiary care center were followed up till well and discharged, or, till death to assess risk and rate of mortality. RESULTS: The baseline median values of total, direct and indirect bilirubin in the cohort of 21.8, 1.6 and 18.6 mg/dl, respectively, were used as cut-offs for high and low levels. Using survival analyses i.e. Kaplan-Meier plots, logrank tests and multivariate Cox proportional hazards regression models to adjust for other strong predictors such as receipt of breastfeeding, being small for gestational age (SGA) and exchange transfusion, high direct bilirubin (> or = median value of 1.6 mg/dl) was independently associated with a higher and faster mortality. CONCLUSION: This study showed that direct bilirubin has independent and additive prognostic value and due attention should be given to newborns with raised levels.
Subject(s)
Bilirubin/blood , Female , Humans , Hyperbilirubinemia/blood , Infant, Newborn/blood , Male , Poisson Distribution , Predictive Value of Tests , Prognosis , Proportional Hazards Models , ROC CurveABSTRACT
Two hospital delivered full term newborn babies were detected to have cholestatic jaundice in the first week of life. They had raised liver enzyme levels, which gradually declined over a period of one month. Both babies were anti HAV IgM positive on 6th day of life in Case 1 and on 7th day of life in Case 2 respectively. Both the mothers had jaundice 20 and 26 days before delivery and had anti HAV IgM positivity two and three weeks prior to delivery in Case 1 and 2 respectively. Hepatitis A virus is not transmitted vertically from mother to baby. However, there are 3 such case reports in literature stating vertical transmission of HAV infection. We are reporting it in two neonates for the first time in India.
Subject(s)
Female , Hepatitis A/transmission , Humans , India , Infant, Newborn , Infectious Disease Transmission, Vertical , PregnancyABSTRACT
A pair of monozygotic twins having tetralogy of Fallot is reported for the first time in the Indian literature. This case report will help in further enriching the existing data on genetic hypothesis of congenital heart defects.