The Association between Total Serum Bilirubin and Kernicterus Spectrum Disorder in Newborn Infants: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Nai Ming Lai ◽  
Joanna Priya Gerard ◽  
Chin Fang Ngim ◽  
Azanna Ahmad Kamar ◽  
Kee-Hsin Chen
Keyword(s):  
Systematic Review ◽  
Serum Bilirubin ◽  
Meta Analysis ◽  
Newborn Infants ◽  
Total Serum Bilirubin ◽  
Spectrum Disorder ◽  
Total Serum

SERUM ALBUMIN RESERVE PSP DYE BINDING CAPACITY IN INFANTS WITH KERNICTERUS

PEDIATRICS ◽  
1967 ◽  
Vol 39 (6) ◽  
pp. 876-883
Author(s):  
J. F. Lucey ◽  
T. Valaes ◽  
S. A. Doxiadis
Keyword(s):  
Serum Concentration ◽  
Serum Albumin ◽  
Serum Bilirubin ◽  
Binding Capacity ◽  
Newborn Infants ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Clinically Normal ◽  
Dye Binding

Observations have been reported on the serum albumin PSP reserve dye binding capacity in a group of 93 newborn infants with total serum bilirubin concentrations ranging between 20 to 52 mg/100 ml. Eleven of these infants had a clinically established diagnosis of kernicterus at the time of these measurements. The PSP reserve dye binding capacity in these neurologically damaged infants was not different from that found in clinically normal infants with the same degree of jaundice. We, therefore, do not believe that this test is sufficiently sensitive to serve as a useful adjunct in assaying the risk of neurologic damage at a particular serum concentration of bilirubin.

scholarly journals Phenobarbital and Phototherapy Combination Enhances Decline of Total Serum Bilirubin and May Decrease the Need for Blood Exchange Transfusion in Newborns with Isoimmune Hemolytic Disease

2015 ◽  
Vol 9 ◽  
pp. CMPed.S24909 ◽  
Author(s):  
Mahmoud A. F. Kaabneh ◽  
Ghassan S. A. Salama ◽  
Ayoub G. A. Shakkoury ◽  
Ibrahim M. H. Al-Abdallah ◽  
Afrah Alshamari ◽  
...  
Keyword(s):  
Exchange Transfusion ◽  
Serum Bilirubin ◽  
Newborn Infants ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Hemolytic Disease ◽  
Blood Exchange ◽  
Blood Exchange Transfusion ◽  
Group 2 ◽  
Group 1

Objective The objective of this study was to evaluate the effect of phenobarbital and phototherapy combination on the total serum bilirubin of the newborn infants with isoimmune hemolytic disease (IHD) and its impact on blood exchange transfusion rates. Patients and Method This single-blinded, prospective, randomized, controlled trial was conducted between March 2013 and December 2014 at the pediatric ward of two Military Hospitals in Jordan. A total of 200 full-term neonates with IHD were divided randomly into two groups: (1) the phenobarbital plus phototherapy group ( n = 103), and (2) the phototherapy-only group ( n = 97). Infants in group 1 received an oral dose of 2.5 mg/kg phenobarbital every 12 hours for 3 days in addition to phototherapy. The total serum bilirubin was observed. Results Of the total 200 included newborn infants, 186 infants completed the study: 97 infants were included in group 1 and 89 infants in group 2. The difference between the mean total serum bilirubin levels at 24, 48, and 72 hours after starting the trial was clinically and statistically significant at P < 0.05. The differences between the two groups were also statistically significant at P < 0.05. Of the total 186 who completed the study, only 22 underwent blood exchange transfusion [7 from group 1, and 15 from group 2 ( P = 0.0478)]. Conclusion In a limited-resources setting, phenobarbital in combination with phototherapy may be helpful to newborn infants with IHD, as it results in a faster decline in total serum bilirubin, thus decreasing the need for blood exchange transfusion than phototherapy alone.

scholarly journals The value of transcutaneous method of bilirubin measurement in newborn population with the risk of ABO hemolytic disease

Medicina ◽  
2009 ◽  
Vol 45 (10) ◽  
pp. 792 ◽  
Author(s):  
Dalia Stonienė ◽  
Jūratė Buinauskienė ◽  
Eglė Markūnienė
Keyword(s):  
Bilirubin Level ◽  
Predictive Value ◽  
Serum Bilirubin ◽  
Newborn Infants ◽  
Serum Bilirubin Level ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Hemolytic Disease ◽  
Significant Difference ◽  
Abo Hemolytic Disease

Objective of the study. To evaluate the correlation between total serum bilirubin (TSB) and transcutaneous bilirubin (TcB) levels in newborn infants at risk of ABO hemolytic disease. Material and methods. During a prospective study, 130 full-term (≥37 weeks of gestation) newborn infants with diagnosed ABO blood group incompatibility were examined. TSB level was measured at the age of 6 hours; further measurements were performed at 24, 48, and 72 hours following the first measurement. Blood samples were collected from the peripheral veins. In clinical laboratory, total serum bilirubin level was measured using Jendrassik-Grof method. TcB level in the forehead was measured using a noninvasive bilirubinometer BiliCheck (SpectRX Inc, Norcross, GA) according to the manufacturer’s instructions within ±30 min after getting a blood sample. Results. During the study, 387 double tests were performed to measure TSB and TcB levels. TSB level (114.83 [62.85] μmol/L) closely correlated with TcB level (111.51 [61.31] μmol/L) (r=0.92, P<0.001). The strongest correlation was reported at the age of 54 hours (r=0.873, P<0.001), the weakest – at the age of 6 hours (r=0.729, P<0.001). TSB and TcB levels showed a strong correlation; the difference between these values was significant (95% CI, 0.70; 5.93; P<0.05). The greatest difference between TSB and TcB levels was detected at the age of 6 hours (5.58 [17.46] μmol/L, 95% CI, 2.55; 8.61; P<0.001). No significant difference was reported at the age of 30, 54, and 78 hours. Using linear regression analysis, it was established that correlation of TSB and TcB was described by equation y=14.13+0.903x. Transcutaneously measured bilirubin level underestimated serum bilirubin level. When at the age of 6 hours TcB level is ≥98 μmol/L, ABO hemolytic disease in newborns may be diagnosed with 100% sensitivity and 98% specificity; positive predictive value was 62% and negative predictive value was 100%. While a newborn’s age increases, TcB sensitivity and specificity for diagnosing ABO hemolytic disease decrease. Conclusion. While evaluating bilirubin level transcutaneously according to nomograms of serum bilirubin level, the results should be considered with caution, especially for newborns with a risk of ABO hemolytic disease. The hour-specific nomograms of transcutaneous

scholarly journals Genome-wide association meta-analysis for total serum bilirubin levels

2009 ◽  
Vol 18 (14) ◽  
pp. 2700-2710 ◽  
Author(s):  
A. D. Johnson ◽  
M. Kavousi ◽  
A. V. Smith ◽  
M.-H. Chen ◽  
A. Dehghan ◽  
...  
Keyword(s):  
Serum Bilirubin ◽  
Meta Analysis ◽  
Total Serum Bilirubin ◽  
Genome Wide Association ◽  
Total Serum ◽  
Genome Wide

scholarly journals Intervention to Reduce Bilirubin Levels in Newborn Babies: A Systematic Review

2020 ◽  
pp. 41
Author(s):  
Kusila Devia Rahayu ◽  
Yeti Hernawati ◽  
Irma Agustiani
Keyword(s):  
Systematic Review ◽  
Literature Review ◽  
Literature Search ◽  
Serum Bilirubin ◽  
Serum Bilirubin Level ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Infant Massage ◽  
Early Initiation Of Breastfeeding ◽  
Initiation Of Breastfeeding

Hyperbilirubin in newborns requires prompt and prompt intervention. A newborn is categorized as hyperbilirubun if there is an increase in the total serum bilirubin level to> 5 mg / dl. Treatment for lowering bilirubin levels can be done medically and non-medically. The many choices of interventions to reduce bilirubin levels in newborns make researchers feel the need to conduct a systematic literature review. Literature search was performed on reputable data based on google scholar, PubMed, Proquest, Ebsco and Medline using the keyword "Intervention AND to reduce bilirubin levels AND Newborn". In the literature search stage, the researcher found 11,959 articles. The literature collection was carried out using the Joana Briggs Institute Critical Appraisal tools for analytical cross-sectional and analytical case control. The literature selection was carried out using PRISMA: Preferred Reporting Item For Systematic Review and Meta-Analysis. At the stage of selecting literature the researcher found 100 suitable articles. Literature analysis and synthesis were performed using matrix review tables and matrix synthesis tables. In the literature synthesis stage, the researcher found 10 suitable articles. The results of the systematic literature review show that the intervention of infant massage, photo therapy, early initiation of breastfeeding and the use of Billy Blanket can reduce the total serum bilirubin levels of newborns and prevent kernicterus. Infant massage interventions, photo therapy, early initiation of breastfeeding, breastfeeding every 2 hours and the use of Billy Blanket can significantly reduce total serum bilirubin levels and percutaneous bilirubin levels. Health workers need to increase their competence to select and determine the type of intervention that can be used to reduce the serum bilirubin level of newborns appropriately.

The Association between Serum Bilirubin and Kernicterus Spectrum Disorder: A Systematic Review and Meta-Analysis

Neonatology ◽  
2021 ◽  
pp. 1-11
Author(s):  
Nai Ming Lai ◽  
Joanna Priya Gerard ◽  
Chin Fang Ngim ◽  
Azanna Ahmad Kamar ◽  
Kee-Hsin Chen
Keyword(s):  
Risk Factors ◽  
Attention Deficit Disorder ◽  
Serum Bilirubin ◽  
Meta Analysis ◽  
Random Effect ◽  
Multivariable Analysis ◽  
Analysis Data ◽  
Spectrum Disorder ◽  
Total Serum ◽  
Neurodevelopmental Outcomes

<b><i>Background:</i></b> Total serum bilirubin (TSB) is used in managing neonates with jaundice, but clear evidence on its association with major outcomes is lacking. <b><i>Objectives:</i></b> We evaluated the association between TSB and kernicterus spectrum disorder (KSD). <b><i>Methods:</i></b> We searched PubMed, EMBASE, and CENTRAL till July 2021. Two authors independently selected relevant cohort studies, extracted data (CHARMS checklist), assessed risk of bias (RoB) (QUIPS tool), and rated certainty-of-evidence (Grades of Recommendation, Assessment, Development, and Evaluation). We pooled adjusted odds ratio (aOR) (random-effect) via generic inverse variance methods. <b><i>Results:</i></b> From 2,826 records retrieved, we included 37 studies (<i>n</i> = 648,979). Fifteen studies had low, 16 moderate, and 6 high RoB, with majority having concerns on confounder adjustment and statistical analysis. Twenty-two studies contributed meta-analysis data, and 15 were summarized narratively. TSB appears associated with KSD in infants with certain risk factors (aOR 1.10, 95% CI: 1.07–1.13; 5 studies [<i>n</i> = 4,484]). However, TSB (aOR 1.10, 95% CI: 0.98–1.23; 1 study [<i>n</i> = 34,533]) or hyperbilirubinemia (aOR 1.00, 95% CI: 0.51–1.95; 2 studies [<i>n</i> = 56,578]) have no clear association with kernicterus or neurological diagnosis in overall neonatal population (moderate-certainty-evidence). One study shows that infants with hyperbilirubinemia appear likelier to develop attention-deficit disorder (aOR 1.90, 95% CI: 1.10–3.28) and autistic spectrum disorder (aOR 1.60, 95% CI: 1.03–2.49, <i>n</i> = 56,019) (low-certainty-evidence). Certain clinical factors appear associated with KSD, although very few studies contributed to the analyses. <b><i>Conclusions:</i></b> Despite the importance of this question, there is insufficient high-quality evidence on the independent prognostic value of TSB for adverse neurodevelopmental outcomes in most neonatal populations. Future studies should incorporate all known risk factors alongside TSB in a multivariable analysis to improve certainty-of-evidence.

Two Different UGT1A1 Mutations causing Crigler–Najjar Syndrome types I and II in an Iranian Family

2015 ◽  
Vol 24 (4) ◽  
pp. 523-526 ◽  
Author(s):  
Yoshihiro Maruo ◽  
Mahdiyeh Behnam ◽  
Shinichi Ikushiro ◽  
Sayuri Nakahara ◽  
Narges Nouri ◽  
...  
Keyword(s):  
Serum Bilirubin ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Compound Heterozygous ◽  
Type I ◽  
Syndrome Type ◽  
Type Ii ◽  
Wild Type ◽  
Iranian Family ◽  
Udp Glucuronosyltransferase

Background: Crigler–Najjar syndrome type I (CN-1) and type II (CN-2) are rare hereditary unconjugated hyperbilirubinemia disorders. However, there have been no reports regarding the co-existence of CN-1 and CN-2 in one family. We experienced a case of an Iranian family that included members with either CN-1 or CN-2. Genetic analysis revealed a mutation in the bilirubin UDP-glucuronosyltransferase (UGT1A1) gene that resulted in residual enzymatic activity.Case report: The female proband developed severe hyperbilirubinemia [total serum bilirubin concentration (TB) = 34.8 mg/dL] with bilirubin encephalopathy (kernicterus) and died after liver transplantation. Her family history included a cousin with kernicterus (TB = 30.0 mg/dL) diagnosed as CN-1. Her great grandfather (TB unknown) and uncle (TB = 23.0 mg/dL) developed jaundice, but without any treatment, they remained healthy as CN-2. Results: The affected cousin was homozygous for a novel frameshift mutation (c.381insGG, p.C127WfsX23). The affected uncle was compound heterozygous for p.C127WfsX23 and p.V225G linked with A(TA)7TAA. p.V225G-UGT1A1 reduced glucuronidation activity to 60% of wild-type. Thus, linkage of A(TA)7TAA and p.V225G might reduce UGT1A1 activity to 18%–36 % of the wild-type. Conclusion: Genetic and in vitro expression analyses are useful for accurate genetic counseling for a family with a history of both CN-1 and CN-2. Abbreviations: CN-1: Crigler–Najjar syndrome type I; CN-2: Crigler–Najjar syndrome type II; GS: Gilbert syndrome; UGT1A1: bilirubin UDP-glucuronosyltransferase; WT: Wild type; TB: total serum bilirubin.

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