prophylactic effect of lactulose on neonatal hyperbilirubinemia by acceleration of meconium passage

ABSTRACT

One of the causes of neonatal hyperbilirubinemia is increased reabsorption of bilirubin from meconium in the gastrointestinal tract. This occurs when the conjugated bilirubin which is excreted into the colon is unconjugated by beta glucuronidase activity, present in the neonatal intestine, which hydrolyzes bilirubin diglucuronide into unconjugated bilirubin, which subsequently is reabsorbed into the portal circulation, contributing to the bilirubin overload on hepatic excretory pathways. Thus, delayed passage of meconium can cause an elevation in the serum bilirubin level. We accelerated meconium transit by lactulose and evaluated the relationship between meconium passage, neonatal jaundice and bilirubin level. 150 newborns were selected after birth in Tabriz Al-zahra Hospital with special criteria. Half of them were given 4.5-5 mL lactulose by gavage 2 hours after birth. Time of meconium passage, appearance of jaundice and level of bilirubin were studied in both groups. Results showed that 40% of neonates in the study group and 26.6% in the control group were non-icteric. Bilirubin level more than 12 mg/dL was seen in 28% of the study group and 53.4% of neonates in the control group. There was a statistically significant correlation between lactulose receivers and the control group [p=0.0028]. This investigation showed that acceleration of meconium passage in newborns decreases the incidence of jaundice and hyperbilirubinemia