High levels of pathological jaundice in the first 24 hours and neonatal hyperbilirubinaemia in an epidemiological cohort study on the Thailand-Myanmar border.
Bilirubin
/ blood
Cohort Studies
Epidemiologic Studies
Ethnicity
/ genetics
Female
Genotype
Glucosephosphate Dehydrogenase Deficiency
/ blood
Humans
Hyperbilirubinemia, Neonatal
/ blood
Infant, Newborn
Kernicterus
/ blood
Male
Myanmar
/ epidemiology
Pre-Eclampsia
/ blood
Pregnancy
Proportional Hazards Models
Prospective Studies
Risk Factors
Thailand
/ epidemiology
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2021
2021
Historique:
received:
08
03
2021
accepted:
20
09
2021
entrez:
7
10
2021
pubmed:
8
10
2021
medline:
25
11
2021
Statut:
epublish
Résumé
Population risks for neonatal hyperbilirubinaemia (NH) vary. Knowledge of local risks permits interventions that may reduce the proportion becoming severe. Between January 2015 and May 2016, in a resource-limited setting on the Thailand-Myanmar border, neonates from 28 weeks' gestation were enrolled into a prospective birth cohort. Each neonate had total serum bilirubin measurements: scheduled (24, 48, 72 and 144 hours of life) and clinically indicated; and weekly follow up until 1 month of age. Risk factors for developing NH were evaluated using Cox proportional hazard mixed model. Of 1710 neonates, 22% (376) developed NH (83% preterm, 19% term). All neonates born <35 weeks, four in five born 35-37 weeks, and three in twenty born ≥38 weeks had NH, giving an overall incidence of 249 per 1000 livebirths [95%CI 225, 403]. Mortality from acute bilirubin encephalopathy was 10% (2/20) amongst the 5.3% (20/376) who reached the severe NH threshold. One-quarter (26.3%) of NH occurred within 24 hours. NH onset varied with gestational age: at a median [IQR] 24 hours [24, 30] for neonates born 37 weeks or prematurely vs 59 hours [48, 84] for neonates born ≥38 weeks. Risk factors for NH in the first week of life independent of gestational age were: neonatal G6PD deficiency, birth bruising, Sgaw Karen ethnicity, primigravidae, pre-eclampsia, and prolonged rupture of membranes. The genetic impact of G6PD deficiency on NH was partially interpreted by using the florescent spot test and further genotyping work is in progress. The risk of NH in Sgaw Karen refugees may be overlooked internationally as they are most likely regarded as Burmese in countries of resettlement. Given high levels of pathological jaundice in the first 24 hours and overall high NH burden, guidelines changes were implemented including preventive PT for all neonates <35 weeks and for those 35-37 weeks with risk factors.
Identifiants
pubmed: 34618852
doi: 10.1371/journal.pone.0258127
pii: PONE-D-21-07620
pmc: PMC8496801
doi:
Substances chimiques
Bilirubin
RFM9X3LJ49
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0258127Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Lancet. 2004 Jan 10;363(9403):157-63
pubmed: 14726171
Pediatrics. 2012 Mar;129(3):e827-41
pubmed: 22371471
Clin Perinatol. 2016 Jun;43(2):215-32
pubmed: 27235203
Evid Based Child Health. 2013 Jan;8(1):204-49
pubmed: 23878128
Pediatrics. 2018 Feb;141(2):
pubmed: 29305393
J Matern Fetal Neonatal Med. 2020 May;33(9):1526-1531
pubmed: 30407090
Lancet Child Adolesc Health. 2018 Aug;2(8):610-620
pubmed: 30119720
Lancet. 2014 Aug 2;384(9941):455-67
pubmed: 24853599
BMC Pregnancy Childbirth. 2015 Feb 05;15:17
pubmed: 25652646
PLoS One. 2018 Jun 1;13(6):e0197888
pubmed: 29856776
BMC Pregnancy Childbirth. 2011 Jun 17;11:45
pubmed: 21679475
Paediatr Int Child Health. 2020 Feb;40(1):7-10
pubmed: 31875773
J Perinatol. 2012 Sep;32(9):677-84
pubmed: 22652561
Hosp Pediatr. 2018 May;8(5):269-273
pubmed: 29618489
J Pediatr. 1970 Jul;77(1):1-10
pubmed: 5430794
BMJ Open. 2017 Jul 5;7(6):e017180
pubmed: 28679678
Arch Iran Med. 2020 Feb 01;23(2):128-140
pubmed: 32061076
BMC Pediatr. 2018 Jun 12;18(1):190
pubmed: 29895274
Wellcome Open Res. 2018 Jan 2;3:1
pubmed: 29552643
PLoS One. 2018 Jan 5;13(1):e0190419
pubmed: 29304139
BMC Pediatr. 2013 Jun 14;13:93
pubmed: 23768173
Open Med. 2008;2(4):e99-e110
pubmed: 21602959
BMJ Paediatr Open. 2017 Nov 25;1(1):e000105
pubmed: 29637134
BMC Pediatr. 2017 Jan 21;17(1):32
pubmed: 28109243
PLoS Negl Trop Dis. 2010 Nov 16;4(11):e887
pubmed: 21103367
Wellcome Open Res. 2017 Nov 2;2:72
pubmed: 29181452
Lancet. 2012 Feb 4;379(9814):445-52
pubmed: 22244654
Lancet. 2014 Sep 6;384(9946):857-68
pubmed: 25209487
Pediatrics. 2004 Jul;114(1):297-316
pubmed: 15231951
J Matern Fetal Neonatal Med. 2016;29(15):2434-7
pubmed: 26413983
Pediatrics. 2009 Oct;124(4):1193-8
pubmed: 19786452
PLoS One. 2014 Dec 23;9(12):e116063
pubmed: 25536053
Curr Pediatr Rev. 2017;13(3):199-209
pubmed: 28814249
PLoS One. 2013 Aug 22;8(8):e72721
pubmed: 23991145
J Matern Fetal Neonatal Med. 2018 Apr;31(7):888-894
pubmed: 28320216
Br J Nutr. 2019 Jun;121(12):1413-1423
pubmed: 31006391
Asian J Transfus Sci. 2011 Jan;5(1):3-7
pubmed: 21572705
BMJ Paediatr Open. 2020 May 28;4(1):e000641
pubmed: 32537522
Ultrasound Obstet Gynecol. 2009 Oct;34(4):395-403
pubmed: 19790099
Wellcome Open Res. 2016 Dec 23;1:32
pubmed: 30607368