Time of colostrum discharge of more than six hours as a risk factor for physiological jaundice in neonates
DOI:
https://doi.org/10.53638/phpma.2019.v7.i1.p09Keywords:
Colostrum, physiological jaundice, neonates, BaliAbstract
Background and purpose: Neonatal jaundice is both a physiological and pathological condition. Neonatal physiological jaundice occurs within 3-5 days after the baby is born. Publications about time of colostrum discharge and neonatal jaundice are still limited. This study aims to determine the risk time of colostrum discharge more than 6 hours to physiological jaundice in neonates.
Methods: A case control study was conducted at the Sanglah General Hospital in Denpasar from August to December 2017. The number of cases was 55 neonates with physiological jaundice and the number of controls was 55 neonates without physiological jaundice. Cases and controls were selected by consecutive sampling. The occurrence of physiological jaundice was obtained by direct observation and the degree of jaundice was determined based on the division of Kramer's body zone. Neonates with the Kramer grades I and II at the age of 3-5 days were classified as experiencing physiological jaundice (as cases) and neonates with a Kramer grade of 0 at the age of 3-5 days were classified as not jaundice (as controls). Cases were matched with controls by sex and age of the neonates. Data on maternal socio-demographic characteristics, time of colostrum discharge, early breastfeeding initiation and 24-hour breastfeeding frequency were obtained by interview; data on jaundice was obtained by observation while mode of delivery, parity, history of pre-eclampsia, prematurity, neonatal birth weight, history of birth trauma (cephalic hematoma), history of asphyxia and major congenital abnormalities were obtained from medical records. Multivariate analysis with binary logistic regression was carried out to determine the adjusted odds ratio (AOR) time of colostrum discharge .
Results: The characteristics of cases and controls were found to be similar in terms of maternal education, neonatal age and sex, parity and pre-eclampsia history. Significant time of colostrum discharge >6 hours was found to be associated with physiological jaundice with AOR=2.57 (95%CI: 1.04-6.37). In this study, variables that were not found to be the risk factors of physiological jaundice in neonates were: cesarean delivery (AOR=0.36; 95%CI: 0.09-1.41; p=0.14), breastfeeding frequency within 24 hours (AOR=2.20; 95%CI: 0.47- 10.23; p=0.31) and early breastfeeding initiation (AOR=0.71; 95%CI: 0.19-2.59; p=0.60)
Conclusion: time of colostrum discharge >6 hours is a risk factor for neonatal jaundice. Efforts should be made to accelerate the release of colostrum in order to prevent neonatal jaundice.
References
Ho NK. Neonatal jaundice in Asia. Bailliere’s clinical haematology. 1992. 5(1), 131–142.
Brits H, Adendorff J, Huisamen D, Beukes D, Botha K, Herbst H, et al. The prevalence of neonatal jaundice and risk factors in healthy term neonates at National District Hospital in Bloemfontein. African Journal of Primary Health Care and Family Medicine. 2018; 10(1): 1–6.
Rubaltelli FF. Unconjugated and conjugated bilirubin pigments during perinatal development. Neonatology. 1993; 64(2-3): 104–109.
Nadir SJ, Saleem N, Amin F, Mahmood KT. Rational use of phototherapy in the treatment of physiologic jaundice neonatorum. Journal of Pharmaceutical Sciences and Research. 2011; 3(1): 973–979.
Depra M, Recca R, Marongiu GF. Problems of neonatal jaundice. Minerva Pediatrica, 1974; 26(5): 260–263.
Urs A, Shivashankar S, Simon C. Neonatal jaundice. Education and Inspiration for General Practice. 2010; 3(12): 708–713.
Aride C, Barron J, Benjamin Y. Neonatal jaundice: NICE Clinical Guideline. National Collaborating Centre for Women’s and Children’s Health. 2010. Available at: https://www.nice.org.uk/guidance/cg98/evidence/full-guideline-245411821
Prasetyono DS. Buku pintar ASI eksklusif [Book of exclusive breastfeeding]. 2009. DIVA. Yogyakarta.
Agarwal V, Singh V, Goel SP, Gupta B. Maternal and neonatal factors affecting physiological jaundice in Western UP. Indian Journal of Physiology and Pharmacology. 2007; 51(2): 203–206.
Garosi E, Mohammadi F, Ranjkesh F. The relationship between neonatal jaundice and maternal and neonatal factors: a cross sectional study. Iranian Journal of Neonatology. 2012; 7(1):37-40.
Osborn L, Reiff MI, Bolus R. Jaundice in the full-term neonate: Prospective cohort study. Pediatrics. 1984; 73(4): 520–525.
Sareharto TP, Wijayahadi N. Kadar Vitamin E rendah sebagai faktor risiko peningkatan bilirubin serum pada neonatus: nested case control [Low Vitamin E as a risk factor of the bilirubin increase in neonates]. Sari Pediatri. 2010; 5(11):355-362.
Bilgin BS, Koroglu OA, Yalaz M, Karaman S, Kultursay N. Factors affecting bilirubin levels during first 48 hours of life in healthy infants: a prospective study. Biomed Research International. 2013; 1-6.
Kusika NPS, Lasmini PS. Pengaruh inisiasi menyusu dini terhadap waktu pengeluaran dan perubahan warna mekonium serta kejadian ikterik fisiologis [The influence of early breastfeeding initiation towards the time and color changes of meconium, and the incidence of physiological jaundice]. Jurnal Ilmu Kedokteran. 2015; 9(2): 87–94.
Pohlman MN, Nursanti I, Anto YV. Hubungan inisiasi menyusu dini dengan jaundice neonatorum di RSUD Wates Yogyakarta [The association of early breastfeeding intiation and neonatal jaundice at Wates Hospital Yogyakarta]. 2015; 4(2): 96–103.
Aulia, Ismail D, Sulistyaningsih. Pengaruh inisiasi menyusu dini terhadap terjadinya jaundice neonatorum di RS PKU Muhammadiyah Bantul [The influence of early breastfeeding initiation towards neonatal jaundice at PKU Muhammadiyah Hospital Bantul]. 2016; 2(1): 31–38.
Apriyulan EM. 2017. Hubungan frekuensi pemberian ASI dengan derajat jaundice neonatorum fisologis di PKU Muhammadiyah 1 Yogyakarta (Disertasi) [The association of breastfeeding frequency and the grades of physiological neonatal jaundice at PKU Muhammadiyah 1 Yogyakarta (Dissertation)]. Yogyakarta: Universitas Aisyiyah
Tazami RM, Syah S, Jambi U. Gambaran faktor risiko jaundice neonatorum pada neonatus di Ruang Perinatologi RSUD Raden Mattaher Jambi: cross sectional [Risk factors of neonatal jaundice among neonates in Perinatology Ward, Raden Mattaher Hospital Jambi: cross sectional]. Jambi Medical Journal. 2013; 1(1):1-7.
Maisels MJ, DeRidder JM, Kring EA, Balasubramaniam M. Routine transcutaneous bilirubin measurements combined with clinical risk factors improve the prediction of subsequent hyperbilirubinemia. Journal of Perinatology. 2009; 29(9): 612–617. 20. Suryandari AE, Agustina EE. Perbedaan waktu pemberian kolostrum terhadap kejadian jaundice fisiologis pada bayi baru lahir di RSU Prof. Dr. Margono Soekarjo: Kohort [Time difference of colostrum initiation and physiological jaundice among newborns in Prof. Dr. Margono Soekarjo Hospital: Cohort]. 2013. Involusi Jurnal Ilmu Kebidanan. 2: 1–12
Rohani S, Wahyuni RR. Faktor-faktor yang berhubungan dengan kejadian ikterus pada neonatus [Factors associated with neonatal jaundice]. Jurnal Aisyah: Jurnal Ilmu Kesehatan. 2017; 2(1): 75–80.
Kramer LI. Advancement of dermal icterus in the jaundiced newborn. American Journal of Diseases of Children. 1969; 118(3): 454–458.
Bobak IM, Lowdermilk DL, Jensen MD. Buku Ajar Keperawatan Maternitas [Teaching book on maternity care]. 2005. Jakarta: EGC.
Haryono R, Setianingsih S. Manfaat ASI eksklusif untuk buah hati Anda [The benefits of exclusive breastfeeding for your children]. 2014. Yogyakarta: Gosyen.
Hassan B, Zakerihamidi M. The correlation between frequency and duration of breastfeeding and the severity of neonatal hyperbilirubinemia. Journal of Maternal-Fetal and Neonatal Medicine. 2018; 31(4): 457–463.
Indonesian Pediatric Society. Manajemen laktasi [Lactation management]. 2013. Available at: http://www.idai.or.id/artikel/klinik/asi/manajemen-laktasi diakses tgl 17 Juli 2018
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Ni Kadek Muliawati, I Gusti Ayu Trisna Windiani, Anak Agung Sagung Sawitri, Luh Seri Ani
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
**Creative Commons Attribution 4.0 International License (CC BY 4.0)**
*Welcome to the world of open collaboration and shared creativity! The Creative Commons Attribution 4.0 International License (CC BY 4.0) empowers creators to share their work with the world while maintaining certain rights.*
**Key Points:**
1. **Freedom to Share:** CC BY 4.0 allows creators to share their work globally, granting others the freedom to use, remix, and build upon it.
2. **Attribution Requirement:** Users can use the work for any purpose, even commercially, as long as they provide appropriate credit to the original creator.
3. **Flexibility:** Applicable to various content types—text, images, music, videos—the license fosters a diverse range of creations.
**Common Use Cases:**
- **Education:** Widely used for educational materials, promoting open learning environments.
- **Research:** Applied to scholarly articles, accelerating the dissemination of knowledge.
**How to Use:**
1. **Share:** Share your work with the world, marking it with the CC BY 4.0 license.
2. **Attribution:** Users, when utilizing the work, must provide proper attribution to honor the original creator.
**Conclusion:**
CC BY 4.0 contributes to a more open and collaborative digital landscape. Join the movement of shared knowledge and creativity!
*For full license details, visit [Creative Commons](https://creativecommons.org/licenses/by/4.0/).*
