Causes of severe neonatal hyperbilirubinemia: a multicenter study of three regions in China

Dong, Xiaogang; Wei, Qiufen; Li, Zhankui; Gu, Jie; Meng, Danhua; Guo, Jinzhen; He, Xijing; Sun, Xiaofan; Yu, Zhangbin; Han, Song

doi:10.1007/s12519-021-00422-3

Cited by 9 publications

(8 citation statements)

References 26 publications

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“…Term neonates with normal neurologic development and total serum bilirubin <205 μmol/L were recruited as healthy controls. Based on the peak total serum bilirubin level, neonates with hyperbilirubinemia were classified into 3 groups according to previous literature: mildly increased total serum bilirubin group (205 μmol/L < total serum bilirubin < 342 μmol/L, n = 30) 19 ; severely increased TSB group (342 µmol/L ≤ total serum bilirubin < 428 μmol/L, n = 25) 20 ; and extremely increased TSB group (total serum bilirubin ≥ 428 µmol/L, n = 10). 21 Neonates were also divided into an ABE group (n = 29) and a non-ABE group (n = 36) according to the bilirubin-induced neurologic dysfunction (BIND) scale score.…”

Section: Methodsmentioning

confidence: 99%

Diagnostics Value of Quantitative Magnetic Resonance Imaging (MRI) in Neonatal Acute Bilirubin Encephalopathy

Liu

Zhang

et al. 2023

J Child Neurol

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Background: This study was designed to investigate the diagnostic value of relative signal intensity of globus pallidus on T1-weighted magnetic resonance imaging (MRI) in neonatal acute bilirubin encephalopathy (ABE). Methods: Participants who were recruited in hospital from April 2019 to May 2020 were grouped into mildly increased total serum bilirubin (TSB) group (n = 30), severely increased TSB group (n = 25), or extremely increased TSB group (n = 10) based on the total serum bilirubin level. Bilirubin-induced neurologic dysfunction scale score was used to determine if participants had acute bilirubin encephalopathy. All neonates underwent conventional brain MRI and the relative signal intensity of globus pallidus was measured on T1-weighted images. The diagnostic value of these 3 indices was assessed by receiver operating characteristic curve analysis. Results: There was a significant correlation between relative signal intensity of globus pallidus and total serum bilirubin level in neonates with hyperbilirubinemia (r = 0.551, P < .001). Relative signal intensity of globus pallidus in the extremely increased TSB group was significantly higher than that in severely increased TSB, mildly increased TSB, and healthy control groups. Relative signal intensity of globus pallidus in the acute bilirubin encephalopathy group was significantly higher than that in the non-acute bilirubin encephalopathy group ( P < .01). The area under the receiver operating characteristic curve of the relative signal intensity of globus pallidus was 0.765 ( P < .01), with sensitivity of 0.655 and specificity of 0.861. The area under the curve of the total serum bilirubin and visual inspection of globus pallidus signal was 0.621 and 0.579, respectively. The area under the curve of relative signal intensity was significantly greater than that of total serum bilirubin and visual inspection ( P = .04 for both). Conclusion: Relative signal intensity of globus pallidus, which is an objective assessment, has the potential to be used as a diagnostic tool for acute bilirubin encephalopathy.

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Section: Methodsmentioning

confidence: 99%

Diagnostics Value of Quantitative Magnetic Resonance Imaging (MRI) in Neonatal Acute Bilirubin Encephalopathy

Liu

Zhang

et al. 2023

J Child Neurol

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“…Os fatores de risco para a ocorrência dessa patologia são: hipoglicemia, hipercapnia, acidose, hipotermia, hipóxia, infecções bacterianas, hipoalbuminemia, hemólise aguda por Incompatibilidade Rh ou ABO, drogas que competem com a bilirrubina na ligação com a albumina (benzoatos, salicilatos, sulfanomidas, ceftriaxona, ibuprofeno, diuréticos, como furosemida, clorotiazida, ácido etacrínico), irmão antecedente que precisou de Fototerapia, Brazilian Journal of Health Review, Curitiba, v. 6, n. 2, p.5396-5406, mar./apr., 2023 idade gestacional menor que 38 semanas; aleitamento materno exclusivo, mas abaixo do ideal; há cefalohematoma ou hematomas significativos de trauma de nascimento; possui doença hemolítica; ou ainda a mãe é de ascendência do Sudeste Asiático (Vodret, 2018;Salvador, Oliveira, Borges, Vieira & Balestra, 2018;Hamza, 2019;Reddy & Pandey, 2020;Dong, 2021).…”

Section: Metodologiaunclassified

Kernicterus: relato de caso clínico

Campos¹,

Lopes²

2023

Braz. J. Hea. Rev.

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Introdução: Kernicterus é uma enfermidade crônica, irreversível resultante da toxicidade ocasionada pelo acúmulo de elevada quantidade de bilirrubina indireta no sistema nervoso central, em especial, nos núcleos da base e do tronco cerebral. As principais complicações são atetose, paralisia cerebral distônica, surdez e disfunção intelectual. O presente relato de caso teve como objetivo descrever um caso de Kernicterus em maternidade filantrópica no nordeste do Brasil que teve seguimento no ambulatório de especialidades da referida maternidade. Nasceu a termo, sexo masculino, com boa vitalidade, apresentou nas primeiras 24 horas icterícia neonatal que não melhorou com uso de fototerapia necessitando realizar exsanguinotransfusão no quarto dia de vida com redução satisfatória dos níveis de bilirrubina indireta. No seguimento ele apresentou retardo do neurodesenvolvimento com diagnóstico de paralisia cerebral distônica, aos 2 anos de idade. Conclusão: No caso apresentado, a abordagem multiprofissional foi fundamental para o melhor prognóstico deste paciente.

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“…BIND arises when unbound bilirubin binds to brain tissue, triggering neurotoxicity ( Bhutani and Johnson, 2009 ). Approximately 1.5% of term and late preterm neonates experiencing substantial hyperbilirubinemia may develop BIND ( Dong et al, 2021 ). Despite its potential as a “never event,” BIND continues to pose a global burden ( Bhutani et al, 2013 ; van der Geest et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Clinical and genetic risk factors associated with neonatal severe hyperbilirubinemia: a case–control study based on the China Neonatal Genomes Project

Wang,

Xiao,

Wang

et al. 2024

Front. Genet.

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Objective: We aimed to investigate the clinical and genetic risk factors associated with neonatal severe unconjugated hyperbilirubinemia.Methods: This was a retrospective, 1:1 matched, case–control study. We included 614 neonates diagnosed with severe unconjugated hyperbilirubinemia (serum total bilirubin level ≥425 μmol/L or serum total bilirubin concentration that met exchange transfusion criteria) from the China Neonatal Genomes Project in Children’s Hospital of Fudan University. Clinical exome sequencing data were analyzed using a data analysis pipeline of Children’s Hospital of Fudan University. The factors associated with severe unconjugated hyperbilirubinemia were assessed using univariable and multivariable logistic regression analyses. Interaction analyses were examined between clinical and genetic risk factors.Results: ABO/Rh incompatibility hemolysis (odds ratio [OR] 3.36, 95% confidence interval [CI] 2.32–4.86), extravascular hemorrhage (OR 2.95, 95% CI 2.24–3.89), weight loss (OR 5.46, 95% CI 2.88–10.36), exclusive breastmilk feeding (OR 3.56, 95% CI 2.71–4.68), and the homozygous mutant of UGT1A1 211G>A (OR 2.35, 95% CI 1.54–3.59) were all identified as factors significantly associated with severe unconjugated hyperbilirubinemia. The presence of UGT1A1 211G>A mildly increased the risk of severe unconjugated hyperbilirubinemia caused by ABO/Rh incompatibility hemolysis (OR 3.98, 95% CI 2.19–7.23), although the effect is not statistically significant.Conclusion: ABO/Rh incompatibility hemolysis, extravascular hemorrhage, weight loss, exclusive breastmilk feeding, and the homozygous mutant of UGT1A1 211G>A were found to be risk factors for severe unconjugated hyperbilirubinemia. Clinical factors remain the most crucial and preventable determinants in managing severe unconjugated hyperbilirubinemia, with a minimal genetic contribution. The establishment of preconception care practices and the reinforcement of screening for the aforementioned risk factors are essential steps for preventing severe unconjugated hyperbilirubinemia.

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Causes of severe neonatal hyperbilirubinemia: a multicenter study of three regions in China

Cited by 9 publications

References 26 publications

Diagnostics Value of Quantitative Magnetic Resonance Imaging (MRI) in Neonatal Acute Bilirubin Encephalopathy

Diagnostics Value of Quantitative Magnetic Resonance Imaging (MRI) in Neonatal Acute Bilirubin Encephalopathy

Kernicterus: relato de caso clínico

Clinical and genetic risk factors associated with neonatal severe hyperbilirubinemia: a case–control study based on the China Neonatal Genomes Project

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