Supra-treatment threshold neonatal jaundice: Incidence in HIV-exposed compared to non-exposed neonates at Queen Elizabeth Central Hospital in Blantyre, Malawi

Nakanga, Wisdom P; Patel, Poojan; Panjwani, Shamila; Kawaza, Kondwani

doi:10.4314/mmj.v27i3.7

Cited by 5 publications

(4 citation statements)

References 4 publications

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“…Eight babies in this study developed NNJ and of these, only 1 was HIV-positive -this was a statistically significant finding. The higher incidence of NNJ among the babies of HIV-negative women is in keeping with the findings by Nakanga et al [24] in a study undertaken in Malawi in 2015. They hypothesised that the efavirenz (EFV) in the prevention of mother-to-child transmission (PMTCT) of HIV acted as a fetal liver enzyme inducer that would aid the conjugation of bilirubin.…”

Section: Discussionsupporting

confidence: 90%

Perinatal outcomes in pregnant women presenting with preterm premature rupture of membranes at a regional hospital in KwaZulu- Natal Province, South Africa

2017

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Background. Worldwide, the incidence of preterm premature rupture of membranes (PPROM) is between 1% and 4% of all pregnancies. Objectives. The primary objectives of this study were to describe and compare the perinatal outcomes of HIV-positive and HIV-negative women presenting with PPROM to a regional hospital in KwaZulu-Natal. Methods. This was a retrospective analytical cross-sectional study which reviewed files of pregnant women presenting with premature rupture of membranes at gestation between 28 and 36 completed weeks. These were identified from the labour ward birth register and from the neonatal ward admission book. Categorical and numerical variables pertaining to the method of confirmation of diagnoses, clinical profiles, modes of delivery, maternal outcomes and neonatal outcomes were considered. Results. A total of 87 files were analysed. Forty-six women (53%) were HIV-negative and 41 (47%) were HIV-positive. Fifty-two percent were in the gestational age <34 weeks. Fifty-nine percent (n=51) of women delivered vaginally and 31% (n=27) delivered by caesarean delivery (CD). There was also no statistical significance between the Apgar scores of the HIV-exposed and HIV-unexposed neonates, birth weights and modes of delivery. There was no statistical significance in sepsis rates, the need for ventilation and the duration of hospital stay between the two groups. The odds of developing neonatal jaundice (NNJ) in the HIV-positive group was 0.14 (95% confidence interval (CI) 0-0.93), which was statistically significant. There was no reported maternal or neonatal mortality and no maternal morbidity associated with PPROM in either groups. Conclusion. This study suggests that there are no immediate significant differences in neonatal and maternal outcomes in pregnancies complicated by PPROM between HIV-negative and HIV-positive women on ART except that of NNJ.

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Section: Discussionsupporting

confidence: 90%

Perinatal outcomes in pregnant women presenting with preterm premature rupture of membranes at a regional hospital in KwaZulu- Natal Province, South Africa

2017

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“…This finding is in keeping with a study done in a hospital in Malawi, which showed a higher incidence of jaundice in HIV unexposed neonates as compared to the HIV exposed neonates. One of the possible hypotheses for this finding as postulated by the authors is the use of drugs such as efavirenz, tenofovir, and lamivudine in pregnant and breast-feeding women as part of the prevention of mother-to-child transmission (PMTCT) programme in Malawi Efavirenz may act as a fetal liver enzyme inducer which helps in the conjugation of bilirubin thereby reducing the risk of jaundice in the HIV exposed infants ( 28 ).…”

Section: Discussionmentioning

confidence: 99%

A comparison of weight gain between HIV exposed uninfected and HIV unexposed uninfected infants who received KMC at Chris Hani Baragwanath Academic Hospital

2022

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IntroductionKangaroo Mother Care (KMC) has been associated with improved growth in low birthweight infants and reduction in hypothermia, hypoglycaemia, apnoeas, sepsis, hospital stay, and mortality. The growth of HIV-infected children is poorer than those who are HIV-uninfected. There is paucity of data on weight gain in the HIV-exposed uninfected (HEU) infants compared to HIV-unexposed uninfected (HUU) infants receiving KMC.AimThis study compared the weight gain of HEU and infants HUU from admission to the KMC ward until 12 months corrected age (CA) follow-up visit.MethodsRetrospective record review of the neonates admitted in KMC at Chris Hani Baragwanath Hospital over a 2-year period (2012–2013). The weight gain was assessed via weight velocity using the formula; weight/kg/day from admission to KMC to discharge, and g/ week at term, 3, 6 and 9- and 12-months (CA). The demographics were collected and analyzed using Statistica.ResultsSeventy-seven (129/166) percent of the mothers were HIV negative. HIV negative mothers were younger (25.9 vs. 31.6 years; p = 0.000) and had fewer pregnancies (p = 0.02). There was no difference between the gestational age (30.3 ± 2.53 vs. 30.8 ± 2.88 weeks; p = 0.35) and birthweight (1,345 g ± 234 vs. 1,314 g ± 209; p = 0.47) between HEU and HUU. There were no differences in the weight gain (23.83 g ± 12.2 vs. 23.22 g ± 15.2; p = 0.83) in KMC. There was no differences in weight gain at the different follow-up time points between the two groups.ConclusionBoth HEU and HUU groups of infants showed reasonable weight gain despite maternal HIV status.

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“…Jaundice can be physiological or pathological; physiological jaundice develops in the first week after delivery as a result of increases in bilirubin production due to the destruction of fetal erythrocytes with transient restrictions in conjugated bilirubin, which is often mild and sometimes does not require any treatments. On the other hand, pathological jaundice usually occurs within the first 24 hours or after the first week of birth [5] . In pathological jaundice, increased production of non-conjugated bilirubin decreases hepatic uptake, and increased bilirubin enterohepatic cycle leads to increased non-conjugated bilirubin [6] .…”

Section: Introductionmentioning

confidence: 99%

“…Clinical interventions for jaundice include phototherapy; administration of chemical medications such as phenobarbital; and complete or partial blood exchange transfusion. Given many complications of exchange transfusion in neonates including hypoglycemia, hypocalcemia, the risk of sepsis, thrombocytopenia, and even death [5] , it may be the last choice to reduce bilirubin level in cases of jaundice who do not respond to other treatments [8] . Phototherapy is the most common intervention for the prevention and treatment of severe hyperbilirubinemia [9] .…”

Section: Introductionmentioning

confidence: 99%

The effect of Bilineaster “Cotoneaster” on reducing bilirubin in neonates with jaundice -a triple-blind randomized clinical trial

Aghababaeian¹,

Nirouzad²,

Kiarsi³

et al. 2021

J Adv Pharm Educ Res

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Supra-treatment threshold neonatal jaundice: Incidence in HIV-exposed compared to non-exposed neonates at Queen Elizabeth Central Hospital in Blantyre, Malawi

Cited by 5 publications

References 4 publications

Perinatal outcomes in pregnant women presenting with preterm premature rupture of membranes at a regional hospital in KwaZulu- Natal Province, South Africa

Perinatal outcomes in pregnant women presenting with preterm premature rupture of membranes at a regional hospital in KwaZulu- Natal Province, South Africa

A comparison of weight gain between HIV exposed uninfected and HIV unexposed uninfected infants who received KMC at Chris Hani Baragwanath Academic Hospital

The effect of Bilineaster “Cotoneaster” on reducing bilirubin in neonates with jaundice -a triple-blind randomized clinical trial

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