Hassan Boskabadi1, Gholamali Maamouri2, Shahin
Mafinejad3, Farzaneh Rezagholizadeh4
1,2Neonatal Research Center, Department of Pediatrics, Ghaem
Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran;
3Department of pediatric, Fellowship of Neonatology, MUMS, Mashhad,
Iran; 4Department of pediatric, Ghaem Hospital, MUMS, Mashhad,
Iran
Background: Hemolytic jaundice is the most serious cause of
hyperbilirubinemia among neonates. It may develop to kernicterus due to
misdiagnosis or inappropriate treatment. The aim of this study is to
determine the prevalence rate of hemolytic jaundice, predisposing factors
and assessment of treatment and complications in hemolytic jaundice.
Methods: This prospective descriptive study has been performed on
1568 newborns with jaundice as their chief complaint, in a seven-year period
at Ghaem hospital in Mashhad, Iran. 795 neonates were included in our study
(237 infants with hemolytic jaundice and 558 infants with idiopathic
jaundice). Complete physical examinations and laboratory tests were
performed and data were recorded. Statistical analysis was carried out,
using SPSS 11.5 statistical package.
Results: In the present study, significant differences were
determined between two groups of hemolytic and idiopathic jaundice for total
serum bilirubin, hematocrit, time of jaundice appearance, age of admission,
hospitalization period and incidence of kernicterus (p<0.001). Newborns with
ABO incompatibility (17%), Rh disease (7%), G6PD deficiency (6%) and minor
blood group immunization (2%) were developed to hyperbilirubinemia,
respectively. Among the newborns affected with kernicterus, 12 cases were
placed in group with ABO hemolytic disease (9%), 3 cases were in Rh
isoimmunization group (5.5%), 4 cases were in G6PD deficiency group (8.9%)
and 9 cases were idiopathic (1.6%).
Conclusion: Jaundice due to hemolysis is associated with a higher
serum bilirubin and more complications like kernicterus. ABO incompatibility
was the most common reason of hemolytic jaundice among neonates in north
east of Iran. Special attention to ABO incompatibility and G6PD enzyme
screening may decrease complications and improve the prognosis.
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Citation: Boskabadi H, Maamouri G, Mafinejad S, Rezagholizadeh F.
Clinical Course and Prognosis of Hemolytic Jaundice in Neonates in North
East of Iran. Maced J Med Sci. 2011 Dec 15; 4(4):403-407.
http://dx.doi.org/10.3889/MJMS.1957-5773.2011.0177.
Key words: jaundice; newborn; hemolysis; Blood group incompatibility.
Correspondence: Dr. Hassan Boskabadi. Neonatal Research Center,
Department of Pediatrics, Ghaem Hospital, Mashhad University of Medical
Sciences (MUMS), Mashhad, Iran. Tel.: 0985118412069; 0989155153987;
Fax:985118409612. E-mail: BoskabadiH@MUMS.ac.ir
Received: 28-Apr-2011; Revised: 20-Jul-2011; Accepted: 22-Jul-2011; Online
first: 16-Nov-2011
Copyright: © 2011 Boskabadi H. This is an open access article
distributed under the terms of the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any
medium, provided the original author and source are credited.
Competing Interests: The authors have declared that no competing
interests exist.
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