Clinical evaluation of severe neonatal Hyperbilirubinaemia in a resource-limited setting: a 4-year longitudinal study in south-East Nigeria
Abstract Background Neonatal hyperbilirubinaemia is one of the commonest causes of hospital visit in the neonatal period. When severe, it is a leading cause of irreversible neurological and musculoskeletal disability. Prompt recognition and timely interventions are imperative for a drastic reduction...
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| Format: | Article |
| Language: | English |
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BMC
2018-06-01
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| Series: | BMC Pediatrics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12887-018-1174-z |
| _version_ | 1818249341790322688 |
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| author | Chidiebere D. I. Osuorah Uchenna Ekwochi Isaac N. Asinobi |
| author_facet | Chidiebere D. I. Osuorah Uchenna Ekwochi Isaac N. Asinobi |
| author_sort | Chidiebere D. I. Osuorah |
| collection | DOAJ |
| description | Abstract Background Neonatal hyperbilirubinaemia is one of the commonest causes of hospital visit in the neonatal period. When severe, it is a leading cause of irreversible neurological and musculoskeletal disability. Prompt recognition and timely interventions are imperative for a drastic reduction in complications associated with severe hyperbilirubinaemia in newborns. Methods We report a 4-year descriptive and longitudinal study to determine the causes, clinical presentations and long-term outcomes in newborns admitted for severe neonatal jaundice. Methods: Newborns admitted and managed for severe neonatal jaundice at the Enugu State University Teaching Hospital during a 4-year period were enrolled and followed up for 2 years. Results A total of 1920 newborns were admitted during the study period and 48 were managed for severe hyperbilirubinaemia giving an in-hospital incidence rate of 25 (95% CI 18–32) per 1000 admitted newborns. The mean age of onset was 3.4 ± 0.5 days (range 1–8 days) and hospital presentation from time of first notice was 4.3 ± 0.4 days (range 1–9 days). The total and unconjugated admission serum bilirubin ranged from 7.1 to 71.1 (mean 26 ± 2.5 mg/dl) and 4.2 to 46.3 mg/dl (mean 18.3 ± 9.2) respectively. Earliest sign of severe hyperbilirubinaemia in newborns were: refusal to suck (15.2%) and depressed primitive reflexes (24.5%) while the commonest signs included high pitch cry (11.9%), convulsion and stiffness (6.9%) and vomiting (6.3%) in addition to the former signs. The major causes of severe hyperbilirubinaemia were idiopathic (33.3%), sepsis (35.3%), ABO incompatibility (17.6%) and glucose-6-phosphate dehydrogenase (G6PD) deficiency (11.8%). Long-term sequelae on follow-up included delayed developmental milestone attainment, postural deformities, visual and seizure disorders. Conclusions There is urgent need for continued education for mothers, families and healthcare workers on the danger newborns with jaundice could face if not brought early to the hospital for timely diagnosis and management. |
| first_indexed | 2024-12-12T15:34:58Z |
| format | Article |
| id | doaj.art-205c4bce9e53406b92ebc899e84df779 |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-12-12T15:34:58Z |
| publishDate | 2018-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-205c4bce9e53406b92ebc899e84df7792022-12-22T00:20:01ZengBMCBMC Pediatrics1471-24312018-06-011811710.1186/s12887-018-1174-zClinical evaluation of severe neonatal Hyperbilirubinaemia in a resource-limited setting: a 4-year longitudinal study in south-East NigeriaChidiebere D. I. Osuorah0Uchenna Ekwochi1Isaac N. Asinobi2Child Survival Unit, Medical Research Council UK, The Gambia UnitDepartment of Paediatrics, Enugu State University of Science and TechnologyDepartment of Paediatrics, Enugu State University of Science and TechnologyAbstract Background Neonatal hyperbilirubinaemia is one of the commonest causes of hospital visit in the neonatal period. When severe, it is a leading cause of irreversible neurological and musculoskeletal disability. Prompt recognition and timely interventions are imperative for a drastic reduction in complications associated with severe hyperbilirubinaemia in newborns. Methods We report a 4-year descriptive and longitudinal study to determine the causes, clinical presentations and long-term outcomes in newborns admitted for severe neonatal jaundice. Methods: Newborns admitted and managed for severe neonatal jaundice at the Enugu State University Teaching Hospital during a 4-year period were enrolled and followed up for 2 years. Results A total of 1920 newborns were admitted during the study period and 48 were managed for severe hyperbilirubinaemia giving an in-hospital incidence rate of 25 (95% CI 18–32) per 1000 admitted newborns. The mean age of onset was 3.4 ± 0.5 days (range 1–8 days) and hospital presentation from time of first notice was 4.3 ± 0.4 days (range 1–9 days). The total and unconjugated admission serum bilirubin ranged from 7.1 to 71.1 (mean 26 ± 2.5 mg/dl) and 4.2 to 46.3 mg/dl (mean 18.3 ± 9.2) respectively. Earliest sign of severe hyperbilirubinaemia in newborns were: refusal to suck (15.2%) and depressed primitive reflexes (24.5%) while the commonest signs included high pitch cry (11.9%), convulsion and stiffness (6.9%) and vomiting (6.3%) in addition to the former signs. The major causes of severe hyperbilirubinaemia were idiopathic (33.3%), sepsis (35.3%), ABO incompatibility (17.6%) and glucose-6-phosphate dehydrogenase (G6PD) deficiency (11.8%). Long-term sequelae on follow-up included delayed developmental milestone attainment, postural deformities, visual and seizure disorders. Conclusions There is urgent need for continued education for mothers, families and healthcare workers on the danger newborns with jaundice could face if not brought early to the hospital for timely diagnosis and management.http://link.springer.com/article/10.1186/s12887-018-1174-zNewbornsSevere hyperbilirubinaemiaCausesClinical featuresComplicationsEnugu |
| spellingShingle | Chidiebere D. I. Osuorah Uchenna Ekwochi Isaac N. Asinobi Clinical evaluation of severe neonatal Hyperbilirubinaemia in a resource-limited setting: a 4-year longitudinal study in south-East Nigeria BMC Pediatrics Newborns Severe hyperbilirubinaemia Causes Clinical features Complications Enugu |
| title | Clinical evaluation of severe neonatal Hyperbilirubinaemia in a resource-limited setting: a 4-year longitudinal study in south-East Nigeria |
| title_full | Clinical evaluation of severe neonatal Hyperbilirubinaemia in a resource-limited setting: a 4-year longitudinal study in south-East Nigeria |
| title_fullStr | Clinical evaluation of severe neonatal Hyperbilirubinaemia in a resource-limited setting: a 4-year longitudinal study in south-East Nigeria |
| title_full_unstemmed | Clinical evaluation of severe neonatal Hyperbilirubinaemia in a resource-limited setting: a 4-year longitudinal study in south-East Nigeria |
| title_short | Clinical evaluation of severe neonatal Hyperbilirubinaemia in a resource-limited setting: a 4-year longitudinal study in south-East Nigeria |
| title_sort | clinical evaluation of severe neonatal hyperbilirubinaemia in a resource limited setting a 4 year longitudinal study in south east nigeria |
| topic | Newborns Severe hyperbilirubinaemia Causes Clinical features Complications Enugu |
| url | http://link.springer.com/article/10.1186/s12887-018-1174-z |
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