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Genetic Factors and Delayed TSB Monitoring and Treatment as Risk Factors Associated with Severe Hyperbilirubinemia in Term Neonates Admitted for Phototherapy.
Boo, Nem-Yun; Sin, Shwe; Chee, Seok-Chiong; Mohamed, Maslina; Ahluwalia, Anita Kaur; Ling, Michelle Min-Min; Ong, Han-Kiat.
Affiliation
  • Boo NY; Department of Population Medicine, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Bandar Sungai Long, Selangor, Malaysia.
  • Sin S; Department of Pre-Clinical Science, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Bandar Sungai Long, Selangor, Malaysia.
  • Chee SC; Department of Pediatrics, Selayang Hospital, Selayang, Selangor, Malaysia.
  • Mohamed M; Department of Pediatrics, Selayang Hospital, Selayang, Selangor, Malaysia.
  • Ahluwalia AK; Department of Pediatrics, Selayang Hospital, Selayang, Selangor, Malaysia.
  • Ling MM; Department of Pediatrics, Selayang Hospital, Selayang, Selangor, Malaysia.
  • Ong HK; Department of Pre-Clinical Science, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Bandar Sungai Long, Selangor, Malaysia.
J Trop Pediatr ; 66(6): 569-582, 2020 12 01.
Article in En | MEDLINE | ID: mdl-32577754
OBJECTIVES: This study aimed to determine whether maternal-fetal blood group isoimmunization, breastfeeding, birth trauma, age when first total serum bilirubin (TSB) was measured, age of admission, and genetic predispositions to hemolysis [due to genetic variants of glucose-6-phosphate dehydrogenase (G6PD) enzyme], and reduced hepatic uptake and/or conjugation of serum bilirubin [due to genetic variants of solute carrier organic anion transporter protein family member 1B1 (SLCO1B1) and uridine diphosphate glucuronosyltransferase family 1 member A1 (UGT1A1)] were significant risk factors associated with severe neonatal hyperbilirubinemia (SNH, TSB ≥ 342µmol/l) in jaundiced term neonates admitted for phototherapy. METHODS: The inclusion criteria were normal term neonates (gestation ≥ 37 weeks). Parents/care-givers were interviewed to obtain data on demography, clinical problems, feeding practice and age when first TSB was measured. Polymerase chain reaction-restriction fragment length polymorphism method was used to detect common G6PD, UGT1A1 and SLCO1B1 variants on each neonate's dry blood specimens. RESULTS: Of 1121 jaundiced neonates recruited, 232 had SNH. Logistic regression analysis showed that age (in days) when first TSB was measured [adjusted odds ratio (aOR) = 1.395; 95% confidence interval (CI) 1.094-1.779], age (in days) of admission (aOR = 1.127; 95% CI 1.007-1.260) and genetic mutant UGT1A1 promoter A(TA)7TAA (aOR = 4.900; 95% CI 3.103-7.739), UGT1A1 c.686C>A (aOR = 6.095; 95% CI 1.549-23.985), SLCO1B1 c.388G>A (aOR = 1.807; 95% CI 1.242-2.629) and G6PD variants and/or abnormal G6PD screening test (aOR = 2.077; 95% CI 1.025-4.209) were significantly associated with SNH. CONCLUSION: Genetic predisposition, and delayed measuring first TSB and commencing phototherapy increased risk of SNH.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Bilirubin / Glucuronosyltransferase / Liver-Specific Organic Anion Transporter 1 / Hyperbilirubinemia, Neonatal / Glucosephosphate Dehydrogenase / Liver Type of study: Diagnostic_studies / Etiology_studies / Observational_studies / Risk_factors_studies Limits: Female / Humans / Male / Newborn Language: En Journal: J Trop Pediatr Year: 2020 Document type: Article Affiliation country: Country of publication:

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Bilirubin / Glucuronosyltransferase / Liver-Specific Organic Anion Transporter 1 / Hyperbilirubinemia, Neonatal / Glucosephosphate Dehydrogenase / Liver Type of study: Diagnostic_studies / Etiology_studies / Observational_studies / Risk_factors_studies Limits: Female / Humans / Male / Newborn Language: En Journal: J Trop Pediatr Year: 2020 Document type: Article Affiliation country: Country of publication: