Welcome to the official website of the IFEMED Journal club

MANAGEMENT OF NEONATAL JAUNDICE IN NIGERIA
O.Ogundare
Senior Registrar
WESLEY GUILD HOSPITAL, OAUTHC ILESHA

O.Omole
600Level Medicine, O.A.U Ile-Ife


INTRODUCTION

Jaundice is yellowish discolouration of the skin, sclera and mucous membranes.1 Neonatal jaundice (NNJ) is so common that it can be regarded as a normal physiologic adaptation of the newborn infant to extrauterine life. However, it may also be a symptom or sign of an underlying disease. Neonatal jaundice is due to increased serum levels of bilirubin, a pigment derived mainly from the breakdown of haemoglobin. It becomes clinically visible when serum bilirubin level exceeds 5 mg/dL. Worldwide NNJ is an obsession of neonatologists because of the association between raised unconjugated bilirubin levels and permanent neurological damage.2-6 Newborns produce bilirubin at a rate of 6-8 mg/kg/ day which is more than twice the production rate in adults.7,8 This is due to relatively large red cell mass, shorter red cell life span causing increased red cell turn-over in neonates.9 Bilirubin production in neonates however declines to adult level within 10 to 14 days after delivery.7 The prevalence of neonatal jaundice in clinical practice range between 23–60%.1 Jaundice is noticed during the first week of life in about 60% of term infants and 80% of preterm infants with only a few signifying underlying disease.7,



REFERENCES
1. 1. Ibe BC. Neonatal jaundice. In: Azubike JC, Nkanginieme KEO (eds). Paediatrics and Child Health in a Tropical Region, 1st Edition. Owerri, African Educational Services 1999; 44-51.
2. Tanner MS. Liver disease. In: Hendrickse RG, Barr DGD, Matthews TS (eds). Paediatrics in the Tropics, 1st Edition. London, Blackwell Scientific 1991; 323-35.
3. Owa JA, Osinaike AI. Neonatal morbidity and mortality in Nigeria. Indian J Pediatr 1998; 65: 441-9.
4. Ibrahim M, Udoma MG, Abdulwahab I. Infant mortality at Usman Danfodiyo University Teaching Hospital, Sokoto. Nig J Paediatr 1993; 20: 17-20.
5. Fagbule D, Joiner KT. Pattern of childhood mortality at the University of Ilorin Teaching Hospital. Nig J Paediatr 1987; 14: 1-5.
6. Etuk SJ, Etuk IS, Ekott MI, Udoma EJ. Perinatal outcome in pregnancies booked for antenatal care but delivered outside health facilities in Calabar, Nigeria. Acta Trop 2000; 75: 29-33.
7. Stoll BJ, Kliegman RM. Digestive System Disorders. In: Berhman RE, Kliegman RM, Jenson HB (eds). Nelson Textbook of Pediatrics, 17th Edition. India, WB Saunders Company 2004: 588-98.
8. Maisels MJ. Neonatal hyperbilirubinaemia. In: Klaus MH, Fanarof AA (eds). Care of the High Risk Neonate, 5th Edition. Philadelphia, WB Saunders Company 2001; 324-62.
9. Gartner LM, Herschel M. Jaundice and breastfeeding. Pediatr Clin North America 2001; 48: 389-99.
10. Practice parameter: management of hyperbilirubinaemia in the healthy term newborn. Pediatrics 1994; 94: 558-62.
11. Ogunlesi TA. Managing Neonatal Jaundice at the General Practice and Primary Health Care level: An Overview. Nig J Paeditr 2004; 31:33-8.
12. Owa JA, Taiwo O, Adebiyi JAO, Dogunro SA. Neonatal jaundice at Wesley Guild Hospital Ilesa and Ife State Hospital Ile-Ife. Nig J Paediatr 1989; 16: 23-30.
13.Ahmed H, Hendrickse RG, Yakubu AM, Maxwell SM. Glucose-6-phosphate dehydrogenase (G6PD) status, aflatoxins and neonatal jaundice. Nig J Paediatr 1995; 22: 3-10.
14. Uko EK, Agwunobi SN, Udoh JJ. Glucose -6-phosphate dehydrogenase (G6PD) levels in jaundiced neonate in Calabar. Nig J Med 2003; 12: 98-102.
15. Alikor EAD, Mobolaji-Lawal O. Cerebral palsy. In: Azubike JC, Nkanginieme KEO (eds). Paediatrics and Child Health in a Tropical Region, 1st Edition. Owerri, African Educational Services 1999; 89-94.
16. Kramer LI. Advancement of dermal icterus in the jaundiced newborn. Am J Dis Child 1969; 118: 454-58.
17. Chan MCK. Neonatal jaundice. In: Hendrickse RG (ed). Paediatrics in the Tropics, Current Review. Oxford, ELBS 1985; 13-26.
18. Watchko J. Exchange transfusion in the management of neonatal hyperbilirubinaemia. In Maisels MJ, Watchko JF: (eds): Neonatal Jaundice. London, Harwood Academic 2000;169-76.