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KMID : 0367419660090010011
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Journal of Korean Pediatric Society
1966 Volume.9 No. 1 p.11 ~ p.16
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Neonatal jaundice and serum bilirubin concentration in premature infants.
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權泰喜/Kwon, Tai Hee
馬順子/陳東植/金孝圭/Ma, Soonja/Chin, Dong Shik/Kim, Hyo Kyu
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Abstract
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This report is the clinical observation about the presence of jaundice in neonates during recent 3 years and 7 ionths from January 1962 to July 1965, and based on the ordinary records in the nursery and premature room. The observed newborns were consisted of 529 premature infants, 5582 full term infants and 258 postmature ifants were born at Ewah Womans Univ. Hosp. or admitted from outside soon after birth. This study also icluded the observation for 25 cases of hyperbdirubinemia with 7 cases recieved exchange blood transfusion and cases treated with administration of prednisolone, and for the data of serum bilirubin levels determined by the ticro-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 roup and slight increasing tendency in recent 2 years in full term infants. According to the delivery type, more igh incidence of the jaundice is noted in the group of abnormal delivery, such as C-section delivery and forcep _livery, in both premature and full term infants. Although above difference is not fully understood, it may iggested that the extravascular breakdown in traumatic bleeding and hypoxic state probably due to abnormal !livery 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 z its onset in premature group. In premature group, the significant correlation is not only obtained between the zidence of jaundice and difference of birth weight, but also between the incidence of jaundice of gestational period, :cept the group of gestational period below 28 weeks which showed markedly high incidence of neonatal jaundice. Persistent duration of jaundice in infants with 1,000gm to 1,500gm of birth weight varies from 3 days to over
days, while in the majority of premature infants with over 1,500gm of birth weight it tends to concentrate on he 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 :change blood transfusion, but fortunately it was disappeared without any functional disturbance within 10 onths of age.
Serum bilirubin concentrations, in 43 premature infants, were elevated to their peak levels at 4 days of life id rapidly decreased from 10 days of life.
There was no significant correlation between the degree of serum bilirubin concentration and birth weight or ie time of onset of jaundice, but it was the the tendency that if the times of maximal serum bilirubin levels as more later, its maximal levels was more higher.
Mean maximal level of serum bilirubin concentration was 14.334.21mgm% and mean level in cord blood was 65+2.12mgm %.
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