Neonatal hyperbilirubinemia in U-thong Hospital,Suphanburi Province.

Abstract

Objective : 1. To evaluate incidence, average microbilirubin and hematocrit at first treatment and cause of hyperbilirubinemia in term newborns in U-thong hospital, Suphanburi Province
2. To study the use of 1994 American Academy of Pediatrics guideline for phototherapy in term newborns in U-thong hospital, Suphanburi Province

Methods : Prospective study in term newborns with hyperbilirubinemia, birth weight ≥ 2,500 grams who were born in U-thong hospital, during 1st August 2008 to 31st July 2009. Data of birth weight, microbilirubin and hematocrit before and after treatment were record. One group newborn was treatmented follow the 1994 AAP guideline and another group treated by own pediatriciant.

Results : One hundred and one newborns with hyperbilirubinemia were included in the study, 60 male and 41 female. Average birth weight 3,139.41 ± 400 grams.Average microbilirubin 14.86 ± 3.03 mg/dL, average hematocrit 51.11 ± 7.36 percent at first treatment. Onset of jaundice appears in 87.28 ± 58.00 hrs and average phototherapy treatment were 2.79 ± 1.07 days. Cause of hyperbilirubinemia were unspecific jaundice 80.20 percent (81 newborns), G6PD deficiency 14.85 percent (15 newborns) and positive direct Coombs'test 2.97 percent (3 newborns).

The rate of compliance with 1994 AAP guideline was 35.64 percent (36 newborns) and non compliance with 1994 AAP guideline was 64.36 percent (65 newborns). The non compliance with 1994 AAP guideline which
onset of jaundice in 49-72 hrs was 55.38 percent (36 newborns) and >72 hrs was 44.62 percent (29 newborns). Cause of hyperbilirubinemia in this group was unspecific jaundice 86.15 percent (56 newborns).

Conclusion : Most cause of hyperbilirubinemia in term newborns in U-thong hospital,Suphanburi Province was unspecific jaundice follow with G6PD deficiency.The 1994 AAP guideline should be modified to recommend for neonatal jaundice in U-thong hospital, for effective phototherapy and reduction of unnecessary phototherapy.

Key words : hyperbilirubinemia, newborn