A Study on Early Onset Conjugated Hyperbilirubinemia in  Neonates in a Tertiary Care Centre in Bhagalpur.

Dr Brajesh Kumar; Dr Sushil Bhushan; Dr Anil Kumar

Volume : VII, Issue : VI, June - 2017

A Study on Early Onset Conjugated Hyperbilirubinemia in Neonates in a Tertiary Care Centre in Bhagalpur.

Dr Brajesh Kumar, Dr Sushil Bhushan, Dr Anil Kumar

Abstract :

Objectives : To determine the related risk factors, outcomes of early onset conjugated hyperbilirubinemia in a group of newborn infants and also to determine the incidence of sepsis in these neonates. Methods : 84 newborn infants with conjugated hyperbilirubinemia were retrospectively reviewed. Results : The mean gestational age was 37 weeks, and the mean postnatal age at presentation was 10 days. Blood culture–proven sepsis was identified in 30 babies (35.7% of total). Gram negative bacteria were isolated in 20 cases and E. coli was the most common of these agents (14 cases). Perinatal hypoxia ischemia was the second most frequent etiology (14 patients; 16.7% of total). The other diagnoses were blood group incompatibility (n=10), Down syndrome (n=6), cholestasis associated with parenteral nutrition (n=6), neonatal hepatitis (n=4), metabolic liver disease (n=2), biliary atresia (n=2), portal venous thrombosis (n=2), and unknown (n=8). 26 babies with sepsis recovered completely with treatment, whereas the prognosis for those with perinatal hypoxia–ischemia was very bad. (12 patients out of 14 died). Conclusion : From our study we concluded that early onset cholestatic jaundice in newborn infants is more commonly due to non–hepatic causes like neonatal sepsis and perinatal hypoxia . So it is very important to observe these infants carefully over a period of time before undertaking time consuming or invasive methods to investigate the primary liver disease. There is a felt need for early diagnosis by Pediatricians and other specialists who play a major role in identifying newborn infants with the risk of infantile conjugated hyperbilirubinemia and referring them for intervention at the earliest to ing down the menace of this disease.