Neonatal Jaundice in Preterm Infants with Bilirubin Encephalopathy. 2021

Akihisa Okumura, and Shintaro Ichimura, and Masahiro Hayakawa, and Hiroshi Arai, and Yoshihiro Maruo, and Takashi Kusaka, and Tetsuya Kunikata, and Satoko Kumada, and Ichiro Morioka
Department of Pediatrics, Aichi Medical University, Nagakute, Japan, okumura.akihisa.479@mail.aichi-med-u.ac.jp.

The aim of this study is to clarify bilirubin parameters and its treatment in preterm infants with bilirubin encephalopathy (pBE). We asked the responders to an earlier nationwide Japanese survey on pBE to provide additional information. pBE was diagnosed based on the criteria used in the nationwide survey. We collected data on serum total bilirubin (TB), direct bilirubin (DB), albumin, and unbound bilirubin (UB) levels during the first 8 weeks of life, and on phototherapy and exchange transfusion treatments. We obtained clinical data from 75 patients with pBE from 58 hospitals (response rate of 59%), who were born between 2002 and 2016. The average peak TB level was 12.6 mg/dL (215 μmol/L), and the average age at peak attainment was 19.7 days after birth. Albumin level was <2.5 g/dL in 44 patients, and the peak DB level was ≥2 mg/dL (34.2 μmol/L) in 20 patients. The average peak bilirubin/albumin (B/A) (mg/g) ratio was 3.8 (molar ratio of 0.475), and the average age at peak attainment was 18.6 days. The average peak UB level was 0.67 μg/dL (11.5 nmol/L). The median duration of phototherapy was 6 days, and the median day of the last session was 12. The peak TB level occurred after the last day of phototherapy in 30 of the 61 patients available for comparison. Most patients with pBE lacked marked elevations in serum TB levels and the B/A ratio, the peaks of which were sometimes delayed to >4 weeks after birth.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D007234 Infant, Premature A human infant born before 37 weeks of GESTATION. Neonatal Prematurity,Premature Infants,Preterm Infants,Infant, Preterm,Infants, Premature,Infants, Preterm,Premature Infant,Prematurity, Neonatal,Preterm Infant
D007567 Jaundice, Neonatal Yellow discoloration of the SKIN; MUCOUS MEMBRANE; and SCLERA in the NEWBORN. It is a sign of NEONATAL HYPERBILIRUBINEMIA. Most cases are transient self-limiting (PHYSIOLOGICAL NEONATAL JAUNDICE) occurring in the first week of life, but some can be a sign of pathological disorders, particularly LIVER DISEASES. Icterus Gravis Neonatorum,Neonatal Jaundice,Physiological Neonatal Jaundice,Severe Jaundice in Neonate,Severe Jaundice in Newborn,Jaundice, Physiological Neonatal,Neonatal Jaundice, Physiological
D007647 Kernicterus A term used pathologically to describe BILIRUBIN staining of the BASAL GANGLIA; BRAIN STEM; and CEREBELLUM and clinically to describe a syndrome associated with HYPERBILIRUBINEMIA. Clinical features include athetosis, MUSCLE SPASTICITY or hypotonia, impaired vertical gaze, and DEAFNESS. Nonconjugated bilirubin enters the brain and acts as a neurotoxin, often in association with conditions that impair the BLOOD-BRAIN BARRIER (e.g., SEPSIS). This condition occurs primarily in neonates (INFANT, NEWBORN), but may rarely occur in adults. (Menkes, Textbook of Child Neurology, 5th ed, p613) Bilirubin Encephalopathy,Hyperbilirubinemic Encephalopathy,Encephalopathy, Bilirubin,Encephalopathy, Hyperbilirubinemic,Bilirubin Encephalopathies,Encephalopathies, Bilirubin,Encephalopathies, Hyperbilirubinemic,Hyperbilirubinemic Encephalopathies
D010789 Phototherapy Treatment of disease by exposure to light, especially by variously concentrated light rays or specific wavelengths. Blue Light Therapy,Blue-light Therapy,Light Therapy,Photoradiation Therapy,Red Light Phototherapy,Therapy, Photoradiation,Blue Light Therapies,Blue-light Therapies,Light Phototherapies, Red,Light Phototherapy, Red,Light Therapies,Light Therapies, Blue,Light Therapy, Blue,Photoradiation Therapies,Phototherapies,Phototherapies, Red Light,Phototherapy, Red Light,Red Light Phototherapies,Therapies, Blue Light,Therapies, Blue-light,Therapies, Light,Therapies, Photoradiation,Therapy, Blue Light,Therapy, Blue-light,Therapy, Light
D005078 Exchange Transfusion, Whole Blood Repetitive withdrawal of small amounts of blood and replacement with donor blood until a large proportion of the blood volume has been exchanged. Used in treatment of fetal erythroblastosis, hepatic coma, sickle cell anemia, disseminated intravascular coagulation, septicemia, burns, thrombotic thrombopenic purpura, and fulminant malaria.
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001663 Bilirubin A bile pigment that is a degradation product of HEME. Bilirubin IX alpha,Bilirubin, (15E)-Isomer,Bilirubin, (4E)-Isomer,Bilirubin, (4E,15E)-Isomer,Bilirubin, Calcium Salt,Bilirubin, Disodium Salt,Bilirubin, Monosodium Salt,Calcium Bilirubinate,Hematoidin,delta-Bilirubin,Bilirubinate, Calcium,Calcium Salt Bilirubin,Disodium Salt Bilirubin,Monosodium Salt Bilirubin,Salt Bilirubin, Calcium,delta Bilirubin

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