DOCSLIB.ORG

The Effect of the Use of Oxytocin in Labor on Neonatal Jaundice

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Effect of the Use of Oxytocin in Labor on Neonatal Jaundice http:// ijp.mums.ac.ir Systematic Review (Pages: 6541-6553) The Effect of the Use of Oxytocin in Labor on Neonatal Jaundice: A Systematic Review and Meta-Analysis Robabe Seyedi1, *Mojgan Mirghafourvand 2, Shirin Osouli Tabrizi11 1Department of Midwifery, Students Research Committee, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran. 2Associate Professor, Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Abstract Background: Neonatal Jaundice is a common problem that occurs in most preterm and term neonates. This systematic review aimed to examine the evidence for the effects of oxytocin in labor on neonatal jaundice. Materials and Methods: In this systematic review study, English databases including PubMed, Google Scholar, Embase, Cochrane Library, Scopus, Web of Sciences, and Persian databases including SID, Magiran, and Barakat Knowledge Network System Were searched from Jan 1980 to Dec 2017. Persian and English human clinical trials were targeted. The review was limited to human clinical trials examining the effect of oxytocin in labor on neonatal jaundice. The searched MESH vocabulary was "neonatal hyperbilirubinemia" OR "jaundice" in combination with "oxytocin in labor" OR "induction of labor". Two authors examined the articles separately and the disagreements were resolved through discussion. Results: Out of 583 articles searched in the databases, 440 title, 83 abstracts, and 60 full texts were reviewed, of which 5 English language articles entered the study and 4 articles entered the meta- analysis. Meta-analysis results showed that oxytocin did not affect the serum bilirubin level of the umbilical cord (Mean difference: 1.60; 95% confidence interval [CI]:-2.50 to 5.69; P=0.44; I2=78%). Furthermore, administering oxytocin in labor did not significantly affect serum bilirubin level on days 1 (-0.32; -1.36 to 0.71; P=0.54; I2=72%), and day 3 (3.75; -11.76 to 18.90; P=0.65; I2=63%), while it significantly affected serum bilirubin level on day 2 (-1.63; -2.81 to -0.45; P=0.007; I2=0%). Conclusion: The result of meta-analysis showed that the administration of oxytocin during labor does not affect serum bilirubin level on days 1 and 3, while induction of labor with oxytocin causes serum bilirubin to increase on the second postnatal day. However, due to the high heterogeneity of the studies, better designed clinical trials are recommended to achieve better results. Key Words: Hyperbilirubinemia, Induction, Labor, Neonatal, Oxytocin, Systematic review. *Please cite this article as: Seyedi R, Mirghafourvand M, Osouli Tabrizi Sh.. The Effect of the Use of Oxytocin in Labor on Neonatal Jaundice: A Systematic Review and Meta-Analysis. Int J Pediatr 2017; 5(12): 6541-53. DOI: 10.22038/ijp.2017.26526.2277 *Corresponding Author: Mojgan Mirghafurvand, Associate Professor, Nursing and Midwifery Faculty, Midwifery Department, Tabriz University of Medical Sciences, Tabriz, Iran. Email: [email protected] Received date: Sep.17, 2017; Accepted date: Nov.12, 2017 Int J Pediatr, Vol.5, N.12, Serial No.48, Dec. 2017 6541 The Effect of Oxytocin in Labor on Neonatal Jaundice 1- INTRODUCTION leads to jaundice. The present systematic Neonatal jaundice is a common and review was performed to examine the benign problem that occurs in 60% of term clinical trial evidence of the effects of and near term neonates and 80% of oxytocin on jaundice. This study aimed to preterm neonates (1). Neonatal jaundice determine the effect of administering presents as yellow color in skin, sclera, oxytocin in labor on neonatal jaundice and mucous membranes due to bilirubin compared with spontaneous vaginal accumulation, which is also associated delivery. with increased bilirubinemia (2). The 2- MATERIALS AND METHODS severity of jaundice varies among different neonates and may be related to factors 2-1. Search strategy such as race, feeding method, delivery First, the search in Cochrane started method, gestational age, preeclampsia, with keywords: "neonatal jaundice", gender, maternal diabetes and labor "hyperbilirubinemia", and "oxytocin in induction with oxytocin (3, 4). labor". According to the search, there was Nowadays, in modern obstetrics, oxytocin no review study based on clinical trials on is widely used to stimulate and accelerate the effect of oxytocin in labor on neonatal labor and prevent prolonged labor (5). The jaundice. Then English databases use of oxytocin has reduced the interval including PubMed, Google Scholar, between induction and delivery. The risks Embase, Cochrane Library, Scopus, Web of induction of labor with oxytocin are of Sciences, and Persian databases fetal distress and low Apgar score (6). including SID, Magiran, and Barakat Oxytocin is also associated with side Knowledge Network System were effects such as an increased incidence of searched from Jan 1980 to Dec 2017. neonatal jaundice, possible causes Persian and English human clinical trials including immature activity of glucuronyl- were targeted. The searched MESH transferase, hepatic damage due to vocabulary was "neonatal hypoxia, increased fetal placental hyperbilirubinemia" OR "jaundice" in transportation, increased erythrocyte combination with "oxytocin in labor" OR fragility and mechanical trauma to "induction of labor". erythrocytes (7). 2-2. Study selection Oxytocin is an antidiuretic hormone, and This systematic review collected and causes hyponatremia and hyposmolarity in evaluated clinical trials on the effect of the mother and subsequently in the fetus oxytocin administration in labor on with water retention. Hyposmolarity neonatal jaundice. Persian and English causes swelling of the red blood cells and human clinical trials were targeted. PICO makes them fragile and susceptible to was used as a guide for searching articles: hemolysis (8). Various studies have the participants in this study were term approved the effects of oxytocin on pregnant women with singleton pregnancy, jaundice. Some studies have suggested that with oxytocin intervention for labor the extensive use of oxytocin in labor induction, along with the control group induction is one of the factors leading to including women with spontaneous neonatal jaundice (9-11). Since the vaginal delivery. The study outcome was induction of labor with oxytocin will neonatal jaundice. The exclusion criteria possibly increase neonatal jaundice, so that were absence of a comparison group and jaundice can be prevented by reducing the the comparison of oxytocin with other oxytocin dose in labor (11). Clinical trials therapeutic groups, such as amniotomy, provide the best results to show if oxytocin Int J Pediatr, Vol.5, N.12, Serial No.48, Dec.2017 6542 Seyedi et al. prostaglandin, and misoprostol without a inclusion criteria. Meanwhile, articles that spontaneous vaginal delivery group. were not consistent with the inclusion criteria were completely eliminated. Based 2-3. Assessment quality of articles on the search, 583 articles were found, 578 The researcher collected and evaluated of which were not included in this study clinical trials on the effect of oxytocin for the following reasons: descriptive administration in labor on neonatal studies, not related to the title, not jaundice. Persian and English human examining the desired outcome (neonatal clinical trials were targeted. These studies jaundice), comparing the effects of were evaluated in terms of inclusion oxytocin on jaundice with a Prostaglandin criteria and relevance to the subject of the F2α or amniotomy group, and absence of review study. Out of 583 articles searched spontaneous vaginal delivery control in the databases, 440 title, 83 abstracts and group. Of the five articles entering this 60 full texts were reviewed, of which 5 review study, the article by D'Souza et al. articles entered the study and 4 articles (14) did not enter the meta-analysis entered the meta-analysis. The collected because its results were based on articles were then carefully studied and the frequency (percentage), and its results two authors separately evaluated the title were reported separately (Figure.1). and abstract of all the articles in terms of Total articles (n=583) PubMed (n=15), Magiran (n=5), Embase (n=3), Google scholar (n=550), SID, Barakat Knowledge Network System, Scopus (n=10) Cochran library, Web of science (n=14). Excluded (n=578), due to: Descriptive articles: 415 (71.7%) Neonatal jaundice not examined: 38 (6.5%) Ineligible study design: 25 (4.3%) Unrelated with Title: 55 (9.5%) Absence of spontaneous vaginal delivery in control group 45 (7.7%) Articles meeting criteria for complete data abstraction (n=5 English language study) Fig1: Flowchart of study. Int J Pediatr, Vol.5, N.12, Serial No.48, Dec.2017 6543 The Effect of Oxytocin in Labor on Neonatal Jaundice 2-4. Assessment of risk of bias in 2-4-4. Blinding of outcome assessment included studies (checking for possible detection bias): Risk bias was determined for each of the Low risk of bias: Complete five included articles according to the blinding of the outcome evaluator. following criteria by the two Author of this High risk of bias: No complete Article (RS and SO) separately and the blinding of the outcome evaluator. disagreements were resolved by referring Unclear risk of bias: Insufficient to the third researcher (MM) and through information. discussion. The types of bias studied in 2-4-5. Incomplete outcome data this study according to the Cochrane (checking for possible attrition bias): Handbook (12) were as follows: Low risk of bias: When there are 2-4-1. Random sequence generation no or little missing data, or the reasons for (checking for possible selection bias): the sample loss are the same in the two Low risk of bias: Use of any groups. random process like random numbers High risk of bias: When the amount table, computer random number generator, of missing data is high or the loss in the coin, and dice. two groups is unbalanced. High risk of bias: Use of any non- Unclear risk of bias: Insufficient random process like date of birth, day or information. date of admission, file number.
Load more

Recommended publications
  • Hyperbilirubinemia and Neonatal Infection
    Original Article International Journal of Pediatrics, Vol.1, Serial No.1, Dec 2013 Hyperbilirubinemia and Neonatal Infection Gholamali Maamouri1, Fatemah Khatami1, Ashraf Mohammadzadeh1, Reza saeidi1, Ahmad shah Farhat1, Mohammad Ali Kiani1,*Hassan Boskabadi1 1Neonatal Research Center , Mashhad University of Medical Science (MUMS), Mashhad, Iran. Abstract Introduction: Hyperbilirubinemia is a relatively common disorder among infants in Iran. Bacterial infection and jaundice may be associated with higher morbidity. Previous studies have reported that jaundice may be one of the signs of infection. The aim of this study was to determine the incidence rate, presentation time, severity of jaundice, signs and complications of infection within neonatal hyperbilirubinemia. Materials and Methods: This cross sectional study was conducted between 2003 and 2011, at Ghaem Hospital, Mashhad- Iran. We prospectively evaluated 1763 jaundiced newborns. We finally found 434 neonates who were categorized into two groups.131 neonates as case group (Blood or/and Urine culture positive or sign of pneumonia) and 303 neonates with idiopathic jaundice as control group. Demographic data including prenatal, intrapartum, postnatal events and risk factors were collected by questionnaire. Biochemical markers including bilirubin level, urine and blood cultures were determined at the request of the clinicians. Results: Jaundice presentation time, age on admission, serum bilirubin value and hospitalization period were reported significantly higher among case group in comparison with control group (p<0.0001). Urinary tract infection (UTI), sepsis and pneumonia were detected in 102 (8%), 22 (1.7%) and 7 (0.03%) cases, respectively. Conclusion: We concluded that bacterial infection was a significant cause of unexplained Hyperbilirubinemia among jaundice newborns (10%).
    [Show full text]
  • JMSCR Vol||05||Issue||03||Page 19659-19665||March 2017
    JMSCR Vol||05||Issue||03||Page 19659-19665||March 2017 www.jmscr.igmpublication.org Impact Factor 5.84 Index Copernicus Value: 83.27 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v5i3.210 Maternal and Neonatal Determinants of Neonatal Jaundice – A Case Control Study Authors Sudha Menon1, Nadia Amanullah2 1Additional Professor, Department of Obstetrics and Gynecology, Government Medical College Trivandrum, Kerala, South India 2Msc Nursing Student, Government Nursing College, Trivandrum Corresponding Author Dr Sudha Menon Email: [email protected] ABSTRACT Neonatal jaundice a common condition which affects about 60-80% of newborn and if severe can lead serious neurological sequelae. Determinants include neonatal and maternal factors. A prospective case control descriptive study in a tertiary care centre was done in 62 consecutive cases with neonatal jaundice and 124 consecutive newborns without jaundice served as controls. The major determinants for neonatal jaundice were low birth weight <2.5 kg (OR 24.54 95% CI 10.98 – 54.84 : P<0.0001), birth asphyxia (OR 16.5; 95% CI 4.63- 58.76, P<0.0001), Low APGAR score <7( OR 26.1; 95% CI 3.28- 207.47, P =0.0002), prematurity <37weeks ( OR 28.92 95% CI 12.15-68.82 P=0.0001) Preterm premature rupture of membranes (OR 58.57 95% CI 7.67 -449.87 P<0.0001) and malpresentation (OR 14.64 95% CI 3.16 - 67.792 tailed p =0.00004).The factors which evolved significant on logistic regression were Preterm premature rupture of membranes , gestational age <37 weeks , APGAR score below 7, Birth weight below 2500grams, Birth asphyxia and multiple pregnancy.
    [Show full text]
  • Maternal Experiences About Neonatal Jaundice: a Qualitative Study
    Pediatric Anesthesia and Critical Care Journal 2020;8(2):58-64 doi:10.14587/paccj.2020.10 Maternal experiences about neonatal jaundice: a qualitative study H. Goli1, M. Ansari2, F. Yaghoubinia3 1Instructor, Department of Nursing, Faculty of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran 2Assistant Professor Department of Nursing, Nursing and Midwifery School, Sabzevar University of Medical Sciences, Sabzevar, Iran 3Associate Professor, Community Nursing Research Center, Zahedan University of Medical Sciences, Zahedan, Iran Corresponding author: F. Yaghoubinia, Department of Nursing, Faculty of Nursing and Midwifery, Community Nursing Research Center, Zahedan University of Medical Sciences, Zahedan, Iran Email: [email protected] Keypoints Mothers need to improve their information on jaundice and change their attitude towards it and its treatment. Abstract improve their information on jaundice and change their Introduction attitude towards it and its treatment. Jaundice is the most common clinical condition in the Keywords newborn, requiring medical attention and hospital read- Neonatal, jaundice, qualitative study mission. This study was conducted to explore maternal Introduction experiences regarding their newborn jaundice. Neonatal jaundice may first have been mentioned in a Material and Methods Chinese textbook 1000 years ago. Jaundice is the most In the current qualitative study, conventional content common condition in infants, requiring medical attention analysis approach was used to explain 8 mothers’ experi- and hospital readmission (1). Neonatal jaundice is com- ences and perception of care provision for jaundiced in- mon in neonatal period due to the adaptation of bilirubin fants were metabolism occurring during this time. (2) It is also con- hospitalized in one of the hospitals affiliated to Zahedan sidered a major cause of neonatal morbidity globally, and University of Medical Sciences.
    [Show full text]
  • Effectiveness and Safety of Prenatal Phenobarbital for the Prevention of Neonatal Jaundice
    Pediatr. Res. 14: 947-952 (1980) fetus neonate hyperbilirubinemia phenobarbital Effectiveness and Safety of Prenatal Phenobarbital for the Prevention of Neonatal Jaundice T. VALAES,'~'K. KIPOUROS, S. PETMEZAKI, M. SOLMAN, AND S. A. DOXIADIS Institute of Child Health, Athens, Greece Summary be denied on the basis that such effects have not been observed following therapeutic use of PB in the perinatal period. For this The effect of 100 mg of phenobarbital (PB) at bedtime for the reason, 5 years after the completion of the initial study, a follow- last few wk of pregnancy on the incidence and severity of neonatal up examination of the children exposed to prenatal PB was carried hyperbiirubinemia was studied. No effect was observed in the out with the aim of answering the question of the long-term effects newborns of mothers who took less than ten tablets. In the 1310 of such a preventive treatment (36). newborns of adequately treated mothers (PB 1 1.0 g), the inci- dence of marked jaundice (bilirubin > 16.0 mg/dl) and the need to perform an exchange transfusion were reduced by a factor of six MATERIALS AND METHODS in relation to the incidence in 1553 control infants. A randomly selected group of 415 children (182 control, 233 PB) INITIAL STUDY were reexamined at 61 to 82 months of age. There was no Between October, 1968, and November, 1971, in two areas of difference in the overall morbidity and mortality between the Greece, the island of Lesbos and the city of Athens, pregnant control and treatment group. A detailed neurologic assessment women after informed consent participated in a controlled blind failed to reveal any differences between the two groups.
    [Show full text]
  • PROBLEMS of the NEONATAL PERIOD
    PROBLEMS of the NEONATAL PERIOD Susan Fisher-Owens, MD, MPH, FAAP Associate Clinical Professor of Clinical Pediatrics Associate Clinical Professor of Preventive and Restorative Dental Sciences University of California, San Francisco Zuckerberg San Francisco General Hospital UCSF Family Medicine Board Review: Improving Clinical Care Across the Lifespan San Francisco March 6, 2017 Disclosures “I have nothing to disclose” (financially) …except appreciation to Colin Partridge, MD, MPH for help with slides 2 Common Neonatal Problems Hypoglycemia Respiratory conditions Infections Polycythemia Bilirubin metabolism/neonatal jaundice Bowel obstruction Birth injuries Rashes Murmurs Feeding difficulties 3 Abbreviations CCAM—congenital cystic adenomatoid malformation CF—cystic fibrosis CMV—cytomegalovirus DFA-- Direct Fluorescent Antibody DOL—days of life ECMO—extracorporeal membrane oxygenation (“bypass”) HFOV– high-flow oxygen ventilation iNO—inhaled nitrous oxide PDA—patent ductus arteriosus4 Hypoglycemia Definition Based on lab Can check a finger stick, but confirm with central level 5 Hypoglycemia Causes Inadequate glycogenolysis cold stress, asphyxia Inadequate glycogen stores prematurity, postdates, intrauterine growth restriction (IUGR), small for gestational age (SGA) Increased glucose consumption asphyxia, sepsis Hyperinsulinism Infant of Diabetic Mother (IDM) 6 Hypoglycemia Treatment Early feeding when possible (breastfeeding, formula, oral glucose) Depending on severity of hypoglycemia and clinical findings,
    [Show full text]
  • Guideline for the Evaluation of Cholestatic Jaundice
    CLINICAL GUIDELINES Guideline for the Evaluation of Cholestatic Jaundice in Infants: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition ÃRima Fawaz, yUlrich Baumann, zUdeme Ekong, §Bjo¨rn Fischler, jjNedim Hadzic, ôCara L. Mack, #Vale´rie A. McLin, ÃÃJean P. Molleston, yyEzequiel Neimark, zzVicky L. Ng, and §§Saul J. Karpen ABSTRACT Cholestatic jaundice in infancy affects approximately 1 in every 2500 term PREAMBLE infants and is infrequently recognized by primary providers in the setting of holestatic jaundice in infancy is an uncommon but poten- physiologic jaundice. Cholestatic jaundice is always pathologic and indicates tially serious problem that indicates hepatobiliary dysfunc- hepatobiliary dysfunction. Early detection by the primary care physician and tion.C Early detection of cholestatic jaundice by the primary care timely referrals to the pediatric gastroenterologist/hepatologist are important physician and timely, accurate diagnosis by the pediatric gastro- contributors to optimal treatment and prognosis. The most common causes of enterologist are important for successful treatment and an optimal cholestatic jaundice in the first months of life are biliary atresia (25%–40%) prognosis. The Cholestasis Guideline Committee consisted of 11 followed by an expanding list of monogenic disorders (25%), along with many members of 2 professional societies: the North American Society unknown or multifactorial (eg, parenteral nutrition-related) causes, each of for Gastroenterology, Hepatology and Nutrition, and the European which may have time-sensitive and distinct treatment plans. Thus, these Society for Gastroenterology, Hepatology and Nutrition. This guidelines can have an essential role for the evaluation of neonatal cholestasis committee has responded to a need in pediatrics and developed to optimize care.
    [Show full text]
  • Dizygotic Twins Discordant for Hivand Hepatitis C
    Archives ofDisease in Childhood 1993; 68: 507 507 Dizygotic twins discordant for HIV and hepatitis C virus Arch Dis Child: first published as 10.1136/adc.68.4.507 on 1 April 1993. Downloaded from Karen M Barlow, Jacqueline Y Q Mok Abstract Discussion Twin girls were born at 37 weeks' gestation to a Factors that enhance the risk of mother to child mother infected by HIV and hepatitis C virus. transmission of HIV include advanced maternal Twin 1 had symptomatic HIV infection by 9 disease, preterm delivery, and breast feeding.' months but was negative for hepatitis C virus Although not as well documented, evidence is antibody and RNA. Twin 2 became HIV anti- emerging that hepatitis C virus may also be body negative by 15 months but was positive vertically transmitted from infected mothers to for antihepatitis C virus and RNA. their offspring.2" Epidemiological factors that (Arch Dis Child 1993; 68: 507) predispose to the acquisition of HIV and hepa- titis C virus infections often coincide, especially in areas where injecting drug use is prominent. The vertical transmission of HIV is now well Viral coinfections may exert synergistic effects, established. Recent work has also documented and it has been postulated that where HIV and the transmission ofhepatitis C virus from mother hepatitis C virus coinfections occur, immune to infant. We report a set of dizygotic twins who suppression secondary to maternal HIV infec- were discordant for vertically acquired HIV and tion may result in increased hepatitis C virus hepatitis C virus infection. replication and lead to more efficient transmis- sion to the infant.6 We have shown, in this pair of non-identical Case reports twins, that HIV and hepatitis C virus are trans- Non-identical female twins were born at 37 mitted independently, as suggested by Thaler weeks' gestation by spontaneous vaginal and coworkers.3 It is unlikely that false negative delivery.
    [Show full text]
  • AMERICAN ACADEMY of PEDIATRICS Management of Hyperbilirubinemia in the Newborn Infant 35 Or More Weeks of Gestation
    AMERICAN ACADEMY OF PEDIATRICS CLINICAL PRACTICE GUIDELINE Subcommittee on Hyperbilirubinemia Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation ABSTRACT. Jaundice occurs in most newborn infants. Hyperbilirubinemia”3 for a description of the meth- Most jaundice is benign, but because of the potential odology, questions addressed, and conclusions of toxicity of bilirubin, newborn infants must be monitored this report.) This guideline is intended for use by to identify those who might develop severe hyperbili- hospitals and pediatricians, neonatologists, family rubinemia and, in rare cases, acute bilirubin encephalop- physicians, physician assistants, and advanced prac- athy or kernicterus. The focus of this guideline is to tice nurses who treat newborn infants in the hospital reduce the incidence of severe hyperbilirubinemia and bilirubin encephalopathy while minimizing the risks of and as outpatients. A list of frequently asked ques- unintended harm such as maternal anxiety, decreased tions and answers for parents is available in English breastfeeding, and unnecessary costs or treatment. Al- and Spanish at www.aap.org/family/jaundicefaq. though kernicterus should almost always be prevent- htm. able, cases continue to occur. These guidelines provide a framework for the prevention and management of DEFINITION OF RECOMMENDATIONS hyperbilirubinemia in newborn infants of 35 or more The evidence-based approach to guideline devel- weeks of gestation. In every infant, we recommend that clinicians 1) promote and support successful breastfeed- opment requires that the evidence in support of a ing; 2) perform a systematic assessment before discharge policy be identified, appraised, and summarized and for the risk of severe hyperbilirubinemia; 3) provide that an explicit link between evidence and recom- early and focused follow-up based on the risk assess- mendations be defined.
    [Show full text]
  • When Should We Start Phototherapy in Preterm Newborn Infants?
    256 Jornal de Pediatria - Vol. 80, Nº4, 2004 Redes multicêntricas e a qualidade da atenção neonatal Barros FC e Diaz-Rossello JL Referências 1. Joseph KS, Kramer MS, Marcoux S, Ohlsson A, Wen SW, 6. Jones G, Steketee RW, Black RE, Bhutta ZA, Morris SS. How Alexander A, et al. Determinants of preterm birth rates in many child deaths con we prevent this year? Lancet. 2003;362: Canada from 1981 through 1983 and from 1992 through 1994. 65-71. N Eng J Med. 1998;339:1434-9. 7. Matijasevich A, Barros FC, Forteza C, Diaz-Rossello JL. Atenção 2. Demissie K, Rhoads GG, Ananth CV, Alexander GR, Kramer MS, à saúde de crianças de muito baixo peso ao nascer de Montevidéu, Kogan MD, et al. Trends in preterm birth and neonatal mortality Uruguai: comparação entre os setores públicos e privado. J among blacks and whites in the United States from 1989 to Pediatr (Rio J). 2001;77:313-20. 1997. Am J Epidemiol. 2001;154:307-15. 8. Krauss Silva L, Pinheiro da Costa T, Reis AF, Iamada NO, 3. Bettiol H, Rona RJ, Chinn S, Goldani M, Barbieri MA. Factors Azevedo AP, Albuquerque CP. Avaliação da qualidade da associated with preterm births in Southeast Brazil: a comparison assistência hospitalar obstétrica: uso de corticóides no trabalho of two birth cohorts born 15 years apart. Paediat Perinat de parto prematuro. Cad Saúde Publica. 1999;15:817-29. Epidemiol. 2000;14:30-8. 9. Leone CR, Sadeck LSR, Vaz FC, Almeida MFB, Draque CM, 4. Horta BL, Barros FC, Halpern R, Victora CG.
    [Show full text]
  • Prolonged Neonatal Jaundice in Cystic Fibrosis H
    Arch Dis Child: first published as 10.1136/adc.46.250.805 on 1 December 1971. Downloaded from Archives of Disease in Childhood, 1971, 46, 805. Prolonged Neonatal Jaundice in Cystic Fibrosis H. B. VALMAN, N. E. FRANCE, and P. G. WALLIS From Queen Elizabeth Hospitalfor Children, London, and the Children's Hospital, Sydenham, London Valman, H. B., France, N. E., and Waffis, P. G. (1971). Archives of Disease in Childhood, 46, 805. Prolonged neonatal jaundice in cystic fibrosis. Four patients with cystic fibrosis developed prolonged obstructive jaundice starting in the newborn period. Obstructive biliary cirrhosis was shown post mortem in one of them who died at 5 months from pneumonia, while another dying at 8 years had an histologically normal liver at necropsy. The two survivors were jaundiced for 6 months and 5 weeks respectively, before making a clinical recovery, and in both liver biopsy at the height of the jaundice showed bile stasis. Meconium ileus was present in half of all recorded cases of cystic fibrosis with prolonged neonatal jaundice. Jaundice is probably due to extrahepatic biliary obstruction from bile of increased density, with secondary intrahepatic bile stasis. Increased density of the bile was noted in the Urinary urobilinogen negative; urinary bile pigments earlier descriptions of cystic fibrosis (Andersen, positive. Stool bile pigments negative. Serum bili- 1938), while focal biliary fibrosis associated with rubin direct reaction strongly positive, indirect 8 * 4 mg/ concretions in the intrahepatic bile ducts is a fre- 100 ml; alkaline phosphatase 18 1 KA units/100 ml, quent finding (Bodian, 1952; Di Sant 'Agnese and serum cholesterol 300 mg/100 ml.
    [Show full text]
  • Pioneers in the Scientific Study of Neonatal Jaundice and Kernicterus
    Pioneers in the Scientific Study of Neonatal Jaundice and Kernicterus Thor Willy Ruud Hansen, MD, PhD ABSTRACT. Neonatal jaundice must have been no- thoughts arose or what explanations were proffered ticed by caregivers through the centuries, but the scien- in those early days. However, descriptions of jaun- tific description and study of this phenomenon seem to diced infants appear in some very early medical have started in the last half of the 18th century. In 1785 textbooks. Morgagni supposedly described and dis- Jean Baptiste Thimote´e Baumes was awarded a prize cussed 15 jaundiced infants, all of them his own (as from the University of Paris for his work describing the cited by Hervieux1). clinical course in 10 jaundiced infants. The work by Jaques Hervieux, which he defended for Kernicterus is the German term for jaundice of the his doctor of medicine degree in 1847, was, in many basal ganglia of the brain and is sometimes seen in respects, a landmark. He had autopsied 44 jaundiced infants dying with extreme jaundice. This complica- infants and apparently had clinical observations on tion was primarily seen in infants with severe hyper- many others. His descriptions of pathoanatomical find- bilirubinemia accentuated by hemolysis as in Rhe- ings were very detailed and systematic. A number of his sus-negative immunization. However, kernicterus clinical observations are still thought to be accurate to- has also been described in the absence of hemolysis. day, such as the essentially benign nature of neonatal Afflicted infants often died during the acute phase, jaundice in most cases, the appearance of neonatal jaun- and a neurological condition with choreoathetosis, dice during the first 2 to 4 days of life as well as its gaze paresis, sensorineural deafness, and occasional disappearance within 1 to 2 weeks, and the cephalocau- dal progression of jaundice.
    [Show full text]
  • Neonatal Polycythaemia.Indd
    WEMJ Volume 116 No.3 Article 1 September 2017 Neonatal polycythaemia, blood viscosity, microcirculatory haemolysis and jaundice* Peter M. Dunn, MA, MD, FRCP, FRCOG, Whole mean cord blood haematocrit values FRCPCH for both groups were identical (mean Emeritus professor of perinatal medicine haematocrit 52%). The subsequent heal and child health, University of Bristol, UK capillary haematocrits (and haemoglobin e-mail: [email protected] values) of both groups followed very different trajectories (Fig 1). Those of * Based on a communication to the the infants with delayed cord clamping Neonatal Society, Keele University, June 28th, 19911 usually rose to over 70% and even to over 80% due to the placental transfusion and In 1963 I came to work at Southmead to a transitory shift of plasma out of the Hospital, Bristol to study fetal adaptation vascular compartment into the tissues – to extra-uterine life. ‘the postnatal plasma shift’. One of my main studies involved investigating the impact of the placental This was my fi rst introduction to transfusion on the baby. I did this by signifi cant neonatal polycythaemia and studying two groups of healthy term of its importance soon after birth. At the infants in a randomised controlled trial time (1964) paediatric and neonatal texts (RCT), one group of which had had their made no mention of the subject except in umbilical cords clamped at the moment an occasional reference in relation to the of birth while in the second clamping had twin-to-twin syndrome been delayed for three minutes(2,3). (Fig 2). Fig 2. Identical twins born following a twin-to-twin transfusion.
    [Show full text]