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Neonatal jaundice and serum bilirubin concentration in premature infants.

Journal of the Korean Pediatric Society 1966;9(1):11-16.
Published online January 31, 1966.
Neonatal jaundice and serum bilirubin concentration in premature infants.
Tai Hee Kwon, Soon Ja Ma, Dong Shik Chin, Hyo Kyu Kim
Dept, of Pediat. Ewha Womans University Hosp. Seoul,Korea
初生兒黃疸의 臨床觀察 및 未熟兒의 血淸빌리루빈 濃度
權泰喜, 馬順子, 陳東植, 金孝圭
梨花女子大學校醫科大學 小兒科學敎室
Abstract
This report is the clinical observation about the presence of jaundice in neonates during recent 3 years and 7 months from January 1962 to July 1965, and based on the ordinary records in the nursery and premature ro6m. The observed newborns were consisted of 529 premature infants, 5582 full term infants and 258 postmattire infants were born at Ewah Womans Univ. Hosp, or admitted from outside soon after birth. This study Miso included the observation for 25 cases of hyperbilirubinemia with 7 cases recieved exchange blood transfusion and 6 cases treated with administration of prednisolone, and for the data of serum bilirubin levels determined by the micro-method of Malloy and Evelyn. The incidence of neonatal jaundice is 61.0% in prematures, 17.0% in full terms and 19.8% in postmatures. Definite significance is not obtainable in sex or annual difference, although more high in male infants in each group and slight increasing tendency in recent 2 years in full term infants. According to the delivery type, more high incidence of the jaundice is noted in the group of abnormal delivery, such as C-section delivery and forcep delivery, in both premature and full term infants. Although above difference is not fully understood, it may suggested that the extra vascular breakdown in traumatic bleeding and hypoxic state probably due to abnormal delivery may be one possible role in the presence or aggravation of jaundice in neonates. In the majority of newborns the neonatal jaundice appeared on 3rd and 4th day after birth, but more variable on its onset in premature group. In premature group, the significant correlation is not only obtained between the incidence of jaundice and difference of birth weight, but also between the incidence of jaundice of gestational period, except the group of gestational period below 28 weeks which showed markedly high incidence of neonatal jaundice. Persistent duration of jaundice in infants with l,000gm to l,500gm of birth weight varies from 3 days to over 20 days, while in the majority of premature infants with over l,500gm of birth weight it tends to concentrate on the period from 4 to 14 days, but no difference between the onset of jaundice and its persistent duration was noted.There was marked difference of development between the operated leg and another one in 5 of 7 cases recieved exchange blood transfusion, but fortunately it was disappeared without any functional disturbance within 10 months of age. Serum bilirubin concentrations, in 43 premature infants, were elevated to their peak levels at 4 days of life and rapidly decreased from 10 days of life. There was no significant correlation between the degree of serum bilirubin concentration and birth weight cr the time of onset of jaundice, but it was the the tendency that if the times of maximal serum bilirubin levels was more later, its maximal levels was more higher. Mean maximal level of serum bilirubin concentration was 14.33+4.21mgm% and mean level in cord blood was 2.65±2.12mgm%.


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