CAUSES AND TREATMENT OUTCOMES OF INDIRECT HYPERBILIRUBINEMIA IN NEONATES AT QUANG NINH OBSTETRICS AND PEDIATRICS HOSPITAL
Main Article Content
Abstract
Background:
This study aimed to describe the etiologies and treatment outcomes of indirect hyperbilirubinemia in neonates at Quang Ninh Obstetrics and Pediatrics Hospital from January 1, 2021, to August 31, 2023.
Methods:
A descriptive case-series study combining retrospective and prospective data collection was conducted on 284 neonates diagnosed with indirect hyperbilirubinemia.
Results:
Among the 284 neonates, males accounted for 56.7%; 77.8% were full-term, 22.2% preterm, and 21.8% had low birth weight. Jaundice was detected within the first 72 hours of life in 91.2% of cases. Neonatal infection was the most common cause (37.3%), followed by maternal–fetal blood group incompatibility (32.4%), glucose-6-phosphate dehydrogenase (G6PD) deficiency (4.6%), and congenital hypothyroidism (1.1%); in 37.7% of cases, no definitive cause was identified. Phototherapy alone was administered in 61.6% of cases, while 38.4% required combination therapies, and 3.2% underwent exchange transfusion. Neonates with maternal–fetal blood group incompatibility had a 7.82-fold higher risk of requiring exchange transfusion compared to those without incompatibility (p = 0.012).
Conclusion:
Neonatal infection and maternal–fetal blood group incompatibility are the leading causes of early and severe indirect hyperbilirubinemia and are associated with an increased risk of exchange transfusion in neonates.
Article Details
Keywords
Neonatal jaundice; increased indirect bilirubin; newborn
References
2.Nguyễn Bích Hoàng. Đặc điểm lâm sàng, cận lâm sàng và đánh giá sự phát triển ở trẻ sơ sinh đủ tháng vàng da phải thay máu, Luận án Tiến sĩ, Trường Đại học Y Hà Nội. 2015.
3.Bộ Y Tế. Vàng da tăng Bilirubin gián tiếp. Hướng dẫn chẩn đoán và điều trị một số bệnh thường gặp ở trẻ em. 223-229. 2015.
4.Kemper AR, Newman TB, Slaughter JL, et al. Clinical practice guideline revision: management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2022; (150): e2022058859.
5.Nguyễn Thị Thanh Bình, Nguyễn Thị Thúy Lan. Nghiên cứu một số yếu tố liên quan từ mẹ và con đến vàng da tăng bilirubin gián tiếp ở trẻ sơ sinh tại đơn vị nhi sơ sinh bệnh viện trượng Đại học Y Dược Huế. Tạp chí Y học Việt Nam. 2022; 516 (2): 108-113.
6.Diala UM, Wennberg RP, Abdulkadir I, et al. Patterns of acute bilirubin encephalopathy in Nigeria: a multicenter pre-intervention study. Journal of Perinatology.2018; (38): 873-880.
7.Van der Geest BA, De Mol MJ, Barendse IS, et al. Assessment, management, and incidence of neonatal jaundice in healthy neonates cared for in primary care: a prospective cohort study. Scientific reports. 2022; (12): 1-12.
8.Okulu E, Erdeve Ö, Tuncer O, et al. Exchange transfusion for neonatal hyperbilirubinemia: A multicenter, prospective study of Turkish Neonatal Society. Turkish Archives of Pediatrics. 2021; 56(2):121-126.
9.Nguyễn Minh Nguyệt, Lương Thị Thuyết. Đánh giá kết quả điều trị vàng da tăng bilirubin tự do bằng đèn chiếu hai mặt tại bệnh viện Nhi Thái Bình. Tạp chí Y Dược Thái Bình. 2022; (3): 14-17.
10.Zhang F, Chen L, Shang S, et al. A clinical prediction rule for acute bilirubin encephalopathy in neonates with extreme hyperbilirubinemia: A retrospective cohort study. Medicine. 2020; 99(9):e19364.