Neonatal jaundice at Port-of-Spain General Hospital - abstract

ABSTRACT

Neonatal jaundice is a major cause of morbidity in developing countries. The preventions of kernicterus is one of the goals of paediatricians in these countries. In an attempt to elucidate the aetiology of neonatal jaundice in our population, a prospective study was done at the Port-of Spain General Hospital from 15th June, 1986 to 30th September, 1986. Ninety-five patients were enrolled; 63 percent of the sample were of African descent, 19 percent of East Indian descent and 11 percent of mixed race. Forty-four per cent had ABO incompatibility, and 44 percent had no blood incompatibility, of which 26 percent were glucose-6-phosphate dehydrogenase (G6PD) deficient. G6PD deficiency was found in 21 percent of the total sample. In 33 percent of the sample, the aetiology is unknown. Moderate/severe jaundice (bilirubin > 16 mg/100 ml) was seen in 58 percent of the ABO incompatible group, 55 percent of the "unknown" group, 43 percent of the Rh incompatible group and 75 percent of the G6PD-deficient group. Most of the ABO incompatibility and Rh incompatibility cases (92 percent and 85 percent) developed jaundice within 48 hours of birth. In contrast, only 55 percent of the G6PD-deficient group and 50 percent of the "unknown' group developed jaundice early. Camphor was used by 60 percent of the G6PD-deficient group, 35 percent of the ABO incompatible group and 39 percent of the "unknown" group. Since 1984, there has been an active policy at the Port-of-Spain General Hospital which ensures that all children with ABO incompatibility are observed for forty-eight hours for the development of jaundice. It is recommended that a screening policy for G6PD deficiency should be adopted, since it is an important cause of jaundice in the children, presents later and can cause moderate/severe jaundice. Camphor use should be discouraged since it is a known precipitant of haemolysis in G6PD-deficient individuals (AU)