Page 230 - 16Neonatal Jaundice_compressed

Neonatal jaundice

Bibliographic details Study type and Patient characteristics Methodology and interventions Results Reviewers Comments
Evidence level
All 3 races different = 10.8%

Murki S et al.; Study type: Term (37 completed weeks) Diagnosis of haemolysis was Baseline comparison of two groups Selected population with small sample size
Prospective study neonates with severe non- based on positive direct Coomb’s (kernicterus vs non-kernicterus group) Comparison of baseline characteristics
Year: 2001 haemolytic jaundice. The inclusion test, peripheral blood smear, done
Evidence level: II criteria were reticulocyte count, plasma Higher number of kernicterus infants Methodology not clearly explained
Country: India TSB > 308 micromol/litre, hemoglobin and packed cell delivered vaginally (93% vs 74%, P Confounding variables controlled
absence of hemolysis volumes. < 0.05) (partially)
22 absence of major malformations. oxytocin use was higher in non-kernicterus
Exchange transfusion was done group (26% vs 42%, P < 0.05)
Kernicterus group: whenever total serum bilirubin
babies with stage II bilirubin level reached 342 micromol/litre. Neonatal risk factors
encephalopathy characterised by
presence of opisthotonus, rigidity No statistically significant difference (at P
and sun-setting of eyeballs < 0.05) between the two groups for
n = 14 sex distribution
mean BW 2402 ± 525 g mean gestational age
mean birthweight
mean GA 37.8 ± 0.8 weeks % of small for date (SFD)
Gender: males = 71.4% history of birth asphyxia
Ethnicity: Not reported pH at admission
weight loss
Non-kernicterus group: babies
without features of bilirubin Laboratory parameters
encephalopathy
n = 50 Mean max TSB levels:
mean BW 2654 ± 446 g Kernicterus: 542 ± 171 micromol/litre
mean GA 38.1 ± 1.02 weeks Non-kernicterus: 438 ± 79 micromol/litre
Gender: males = 54% P = 0.002
Ethnicity: Not reported
Free bilirubin levels:
Kernicterus: 25.5 ± 10.1 nmol/litre
Non-kernicterus: 19.9 ± 6.9 nmol/litre
P = 0.006

Bilirubin/albumin ratio:
Kernicterus: 0.14 ± 0.05
Non-kernicterus: 0.11 ± 0.03
P = 0.05

Results from multiple logistic regression
analysis

History of birth asphyxia:

188