Hyperbilirubinemia, Neonatal Clinical Trial
Official title:
The Predictors of the Neonatal Hyperbilirubinemia
The oxygen tension increases more than 3 times from fetus to neonate. The oxidant stress happens. And it will cause the destruction of RBC. So, we propose that the ROS may play an important role of neonatal hyperbilirubinemia. There is strong association between the bilirubin level and ROS levels at 3 days old in our pilot study.
The incidence of neonatal jaundice is higher in Eastern population than western people. The
bilirubin comes from the destruction of RBC which heme is released and catabolized. If the
bilirubin enters into the brain and deposits in basal ganglion, it will cause apoptosis of
the neuronal cells, that is so called kernictrus, which is the major complication of the
neonatal jaundice. However, the bilirubin has its own antioxidant protective effect. Many
clinical or basic studies tried to find out the relationship of bilirubin and reactive
oxygen species (ROS) in recent years.
The American Association of Pediatrics proposed the management principle of neonatal
jaundice in 1994. It postponed the management criteria of neonatal jaundice Besides, early
discharge (before 48 hour-old) was the trend in many countries. It may be dangerous because
the neonatal jaundice appears after 48 hour-old. Whether the criteria and the trend will
cause the elevation of the incidence of kernictrus, is always the major concern of
clinicians. So, searching factors to predict neonatal hyperbilirubinemia causes the interest
of many investigators. The predictors are divided into risk-factor based and normogram
based. But they are still not suitable for all populations.
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Allocation: Random Sample, Observational Model: Natural History, Time Perspective: Longitudinal
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