Extreme neonatal hyperbilirubinaemia in refugee and migrant populations: retrospective cohort.
extreme neonatal hyperbilirubinaemia
kernicterus
limited-resource setting
low-income and middle-income countries
migrant
neonatal hyperbilirubinaemia
neonatal jaundice
neurodevelopment
neurological outcome
refugee
Journal
BMJ paediatrics open
ISSN: 2399-9772
Titre abrégé: BMJ Paediatr Open
Pays: England
ID NLM: 101715309
Informations de publication
Date de publication:
2020
2020
Historique:
received:
12
01
2020
revised:
14
04
2020
accepted:
27
04
2020
entrez:
16
6
2020
pubmed:
17
6
2020
medline:
17
6
2020
Statut:
epublish
Résumé
To describe neonatal survival and long-term neurological outcome in neonatal hyperbilirubinaemia (NH) with extreme serum bilirubin (SBR) values. Retrospective chart review, a one-off neurodevelopmental evaluation. Special care baby unit in a refugee camp and clinics for migrant populations at the Thailand-Myanmar border with phototherapy facilities but limited access to exchange transfusion (ET). Neonates ≥28 weeks of gestational age with extreme SBR values and/or acute neurological symptoms, neurodevelopment evaluation conducted at 23-97 months of age. Neonatal mortality rate, prevalence of acute bilirubin encephalopathy (ABE) signs, prevalence of delayed development scores based on the Griffiths Mental Development Scale (GMDS). From 2009 to 2014, 1946 neonates were diagnosed with jaundice; 129 (6.6%) had extreme SBR values during NH (extreme NH). In this group, the median peak SBR was 430 (IQR 371-487) µmol/L and the prevalence of ABE was 28.2%. Extreme NH-related mortality was 10.9% (14/129). Median percentile GMDS general score of 37 survivors of extreme NH was poor: 11 (2-42). 'Performance', 'practical reasoning' and 'hearing and language' domains were most affected. Four (10.8%) extreme NH survivors had normal development scores (≥50th centile). Two (5.4%) developed the most severe form of kernicterus spectrum disorders. In this limited-resource setting, poor neonatal survival and neurodevelopmental outcomes, after extreme NH, were high. Early identification and adequate treatment of NH where ET is not readily available are key to minimising the risk of extreme SBR values or neurological symptoms.
Identifiants
pubmed: 32537522
doi: 10.1136/bmjpo-2020-000641
pii: bmjpo-2020-000641
pmc: PMC7264833
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e000641Informations de copyright
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
J Nutr. 2003 Dec;133(12):4143-9
pubmed: 14652363
Pediatrics. 2011 Oct;128(4):e925-31
pubmed: 21911352
J Med Assoc Thai. 2005 May;88(5):588-92
pubmed: 16149673
Matern Health Neonatol Perinatol. 2015 Sep 15;1:22
pubmed: 27057339
BMJ Paediatr Open. 2017 Nov 25;1(1):e000105
pubmed: 29637134
PLoS Negl Trop Dis. 2010 Nov 16;4(11):e887
pubmed: 21103367
Neonatology. 2017;111(4):324-330
pubmed: 28073104
Pediatrics. 2014 Sep;134(3):504-9
pubmed: 25092943
PLoS One. 2013;8(1):e54026
pubmed: 23320118
Clin Perinatol. 2016 Jun;43(2):215-32
pubmed: 27235203
Semin Fetal Neonatal Med. 2015 Feb;20(1):52-57
pubmed: 25585889
Pediatr Res. 2013 Dec;74 Suppl 1:86-100
pubmed: 24366465
Am J Perinatol. 2011 May;28(5):405-12
pubmed: 21365530
Pediatrics. 2018 Feb;141(2):
pubmed: 29305393
Optom Vis Sci. 1992 Jun;69(6):427-32
pubmed: 1641223
BMC Pediatr. 2018 Jun 12;18(1):190
pubmed: 29895274
Wellcome Open Res. 2018 Jan 2;3:1
pubmed: 29552643
PLoS One. 2018 Jan 5;13(1):e0190419
pubmed: 29304139
BMC Pediatr. 2015 Apr 12;15:39
pubmed: 25884679
Semin Fetal Neonatal Med. 2015 Feb;20(1):6-13
pubmed: 25577653
Ann Trop Paediatr. 2002 Dec;22(4):355-68
pubmed: 12530286
Semin Perinatol. 2011 Jun;35(3):162-70
pubmed: 21641490
Pediatrics. 2004 Jul;114(1):e130-53
pubmed: 15231986
Acta Paediatr. 2005 Jan;94(1):59-64
pubmed: 15858962
J Trop Pediatr. 2010 Oct;56(5):333-6
pubmed: 20123952
Ultrasound Obstet Gynecol. 2012 Aug;40(2):151-7
pubmed: 22262286
N Engl J Med. 2013 Nov 21;369(21):2021-30
pubmed: 24256380
Pediatrics. 2004 Jul;114(1):297-316
pubmed: 15231951
Curr Pediatr Rev. 2017;13(3):199-209
pubmed: 28814249
Semin Perinatol. 2006 Apr;30(2):89-97
pubmed: 16731283
PLoS One. 2015 Jun 26;10(6):e0131025
pubmed: 26114295
PLoS One. 2013 Aug 22;8(8):e72721
pubmed: 23991145
Arch Dis Child. 2004 Jul;89(7):637-43
pubmed: 15210495
Acta Paediatr. 2008 Jun;97(6):754-8
pubmed: 18422806
BMC Pediatr. 2015 Apr 01;15:28
pubmed: 25884571
World J Clin Pediatr. 2016 May 08;5(2):182-90
pubmed: 27170928
Pediatrics. 2012 Oct;130(4):e886-90
pubmed: 22966025