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Bu çalışmada amaç yenidoğan ünitesine indirekt hiperbilirubinemi tanısıyla yatırılan term bebeklerin klinik ve demografik özellikleri, indirekt hiperbilirubinemi nedenleri ve total bilirubin düzeylerine etki eden risk faktörlerinin araştırılması ve bölgemiz açısından tekrar gözden geçirilmesidir. Çalışmamızda Ocak 2010-Ocak 2012 tarihleri arasında hiperbilirubinemi ön tanısıyla servisimize yatırılan 447 yenidoğan incelenmiştir. Hastaların takip ve tedavisi Amerikan Pediatri Akademisi' nin (APA) tanı ve tedavi önerilerine göre yapılmıştır. Çalışma retrospektif olarak yapılmıştır. Bebekler demografik olarak incelendiğinde yenidoğan ünitesine hiperbilirubinemi nedeniyle yatan bebeklerin %41,8 i ailenin yaşayan ilk bebeğidir. Hiperbilirubinemi ile birlikte hipernatremi görülme oranı %26,2, patolojik tartı kaybı ise %28,9 oranında görülmektedir. Çalışmamızda ele alınan bebeklerin %55,7 si (249) erkek, %44,3 ü (198) kızdır. Erkek /kız oranı 1,25 bulunmuştur. Yenidoğan ünitesine yatan bebeklerin %58,2 si normal spontan doğum (NSD) ile dünyaya gelmiştir. Etiyolojik faktör olarak en sık nedeni bilinemeyen fizyolojik sarılık %36 (n:159) görülürken hemolitik sarılık %30,8 (n:136) , polisitemi %13 (n:58), geç anne sütü sarılığı %8,3 (n:37), üriner sistem enfeksiyonu %6,3 (n:28), hipotiroidi %5,8 (n:26), diabetik anne bebeği % 4,3 (n:19), sepsis %3,8 (n:17), sefal hematom %2,9 (n:13), caput succadeneum %2,2 (n:10), glukoz 6-fosfat dehidrojenaz (G6PD) eksikliği %2 (n:9) oranında görülmüştür. Bebeklerin % 99,8’ine (n:440) fototerapi uygulanırken, kan değişimi tedavisi uygulanan bebek oranı %1,6 (n:7) bulunmuştur. Fototerapi süresi 1 gün ile 15 gün arasında değişmekte olup ortalama fototerapi süresi 2,18±1,37 gündür. Bebeklerin taburculuk süreleri 1 gün ile 20 gün arasında değişmekte olup ortalaması 4,12±2,97 gündür. Sarılık yenidoğan döneminde görülen sık ve önemli sorunlardan birisidir. Bebeklerin çoğunluğunda selim bir seyir görülürken küçük bir bölümünde hiperbilirubinemi yüksek düzeylere çıkmakta ve nörotoksik etkiler ortaya çıkabilmektedir.
The objective of this study is to investigate the clinical and demographic characteristics of the thermal babies infected with the diagnosis of indirect hyperbilirubinemia in the newborn unit, the causes of indirect hyperbilirubinemia and the risk factors affecting the levels of total bilirubin and re-examinate from the point of view of our region. Our study examined 447 newborns who were placed in our service with pre-diagnosis of hyperbilirubinemia between January 2010 and January 2012. Patients are monitored and treated according to the American Academy of Pediatrics (APA) diagnosis and treatment recommendations. The work is retrospective. When demographically studied, 41.8 percent of babies in the newborn unit due to hyperbilirubinemia are the first living babies in the family. With hyperbilirubinemia, the rate of hyperthermia occurred at 26.2%, and pathological loss at 28.9%. In our study, 55.7 percent of the babies addressed are men (249) and 44.3 percent (198) girls. The male and female ratio was 1.25 . 58.2 percent of newborns are born with normal spontaneous birth (NSD). If the etiological factor is unknown, the physiological yellowness is 36% (n:159); hemolithic yellowness is 30.8% (n:136) , polysithemia is 13% (n:58), late breast milk yellowness is 8.3% (n:37), urinary system infection is 6.3% (n:28), hypothyroidism is 5.8% (n:26), diabetic mother baby is 4.3% (n:19), sepsis is 3.8% (n:17), sephal hematom is 2.9% (n:13), caput succadeneum is 2.2 (n:10), glucose 6-phosphate dehydrogenase (G6PD) is lack of 2% (n:9). 99.8 percent of babies (n:440) received phototherapy, while the number of babies (n:7) received blood exchange therapy was 1.6 percent. The phototherapy duration varies from 1 day to 15 days and the average phototherapy duration is 2.18±1.37 days. The period of discharge for babies varies from 1 day to 20 days, with an average of 4.12±2.97 days. Yellowness is one of the common and major problems in the newborn period. The majority of babies have a sickness, while hyperbilirubinemia is high in a small portion and neurotoxic effects can occur.
This study aims clinical and demographic characteristics of hospitalized term newborns with indirect hyperbilirubinemia diagnosed in the neonatal unit, indirect hyperbilirubinemia causes and investigate the risk factors affecting the total bilirubin level and our region is the revised terms. In our study, 447 newborns who were admitted to our department with the diagnosis of hyperbilirubinemia between January 2010 and January 2012 were examined. Follow-up and treatment of patients were made according to the American Academy of Pediatrics (APA) diagnosis and treatment recommendations. The study was conducted retrospectively. The baby is the first child living in the family 41.8 % of babies admitted to the neonatal unit when we examined demographic. Hyperbilirubinemia incidence of hypernatremia with 26.2% and the pathological weight loss is observed by 28.9%. In our study, 55.7% (n:249) of the babies were male and 44.3% (n:198) were female. Male / female ratio of 1:25 has been found. Newborn baby lying in the unit to 58.2% have normal spontaneous delivery (NSD) was born with. The most common cause is known when physiological Jaundice as an etiologic factor in 36% (n:159), while; hemolytic Jaundice 30.8% (n:136), polycythemia 13% (n:58), pass into breast milk jaundice was 8.3% (n:37), urinary tract infection 6.3% (n:28), hypothyroidism was 5.8% (n:26), diabetic mother is 4.3% (n:9), sepsis 3.8% (n:17) Cephalo haematoma 2.9% (n:13), caput succadene % 2.2 (n: 10), glucose 6-phosphate dehydrogenase (G6PD) deficiency 2% (n: 9). While 99.8% (n: 440) of the infants were treated with phototherapy, the rate of infant who received blood exchange treatment was 1.6% (n: 7). Phototherapy period ranges from 1 day to 15 days and 2.18 ± 1.37 in average duration of phototherapy day. The average discharge time of the baby ranged from 20 days to 1 day 12.04 ± 2.97 days. Jaundice is one of the most common and important problems seen in newborn period. While the majority of infants being a benign hyperbilirubinemia in a small part in high level and neurotoxic effects may occur.
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