Articles

Time of colostrum discharge of more than six hours as a risk factor for physiological jaundice in neonates

Ni Kadek Muliawati , I Gusti Ayu Trisna Windiani, Anak Agung Sagung Sawitri, Luh Seri Ani

Ni Kadek Muliawati
Wira Medika Bali Health Insitute. Email: muliawati.wika@gmail.com

I Gusti Ayu Trisna Windiani
Udayana University

Anak Agung Sagung Sawitri
Udayana University

Luh Seri Ani
Udayana University
Online First: July 31, 2019 | Cite this Article
Muliawati, N., Windiani, I., Sawitri, A., Ani, L. 2019. Time of colostrum discharge of more than six hours as a risk factor for physiological jaundice in neonates. Public Health and Preventive Medicine Archive 7(1): 44-48. DOI:10.15562/phpma.v7i1.193


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 colostrum and neonatal jaundice are still limited. This study aims to determine the risk of the onset of colostrum discharge of 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, onset 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) of the onset 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 outset of colostrum >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: Onset 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, N. K. 1992. Neonatal Jaundice in Asia. Bailliere’s Clinical Haematology, 5(1), 131–142. http://doi.org/10.1016/S0950-3536(11)80038-7.

Brits, H., Adendorff, J., Huisamen, D., Beukes, D., Botha, K., Herbst, H., & Joubert, G. The prevalence of Neonatal Jaundice and Risk Factors in Healthy Term Neonates at National District Hospital in Bloemfontein. 2018. African Journal of Primary Health Care and Family Medicine, 10(1), 1–6. http://doi.org/10.4102/phcfm.v10i1.1582

Rubaltelli, F. F. 1993. Unconjugated and Conjugated Bilirubin Pigments during Perinatal Development. Neonatology, 64(2-3), 104–109. http://doi.org/10.1159/000243979

Nadir, S. J., Saleem, N., Amin, F., & Mahmood, K. T. 2011. Rational Use of Phototherapy in the Treatment of Physiologic Jaundice Neonatorum. Journal of Pharmaceutical Sciences and Research, 3(1), 973–979.

Depra, M., Recca, R., & Marongiu, G. F. 1974. Problems of Neonatal Jaundice. Minerva Pediatrica, 26(5), 260–263.

Urs, A., Shivashankar, S., & Simon, C. 2010. Neonatal Jaundice. Innovait: Education and Inspiration for General Practice, 3(12), 708–713. http://doi.org/10.1093/innovait/inq074

Clinical Guideline Neonatal jaundice. 2010. National Collaborating Centre for Women’s and Children’s Health. Royal College of Obstetricians and Gynaecologists https://www.nice.org.uk/guidance/cg98/evidence/full-guideline-245411821

Agarwal, V., Singh, V., Goel, S. P., & Gupta, B. 2007. Maternal and Neonatal Factors Affecting Physiological Jaundice in Western U.P. Indian Journal of Physiology and Pharmacology, 51(2), 203–206.

Garosi, E., Mohammadi, F., & Ranjkesh, F. 2012. The Relationship between Neonatal Jaundice and Maternal and Neonatal Factors: a Cross Sectional Study. Iranian Journal of Neonatology, 7(1):37-40.

Osborn, L. M., Reiff, M. I., & Bolus, R. 1984. Jaundice in the Full-Term Neonate: Prospective Cohort Study. Pediatrics, 73(4), 520–525.

Sareharto, T. P., & Wijayahadi, N. 2010. Kadar Vitamin E Rendah sebagai Faktor Risiko Peningkatan Bilirubin Serum pada Neonatus: Nested Case Control. Sari Pediatri, 5(11):355-362.

Bilgin, B. S., Koroglu, O. A., Yalaz, M., Karaman, S., & Kultursay, N. 2013. Factors Affecting Bilirubin Levels During First 48 Hours of Life in Healthy Infants: a Prospective Study. Biomed Research International, 1-6.

Kusika, N. P. S., & Lasmini, P. S. 2015. Pengaruh Inisiasi Menyusu Dini terhadap Waktu Pengeluaran dan Perubahan Warna Mekonium Serta Kejadian Ikterik Fisiologis. Jurnal Ilmu Kedokteran, 9(2), 87–94.

Pohlman, M. N., Nursanti, I., & Anto, Y. V. 2015. Hubungan Inisiasi Menyusu Dini dengan jaundice Neonatorum Di RSUD Wates Yogyakarta, 4(2), 96–103.

Aulia, Ismail,D.,Sulistyaningsih. 2016. Pengaruh Inisiasi Menyusu Dini terhadap Terjadinya Jaundice Neonatorum di RS PKU Muhammadiyah Bantul, 2(1), 31–38.

Apriyulan, E. M. 2017. Hubungan Frekuensi Pemberian ASI dengan Derajat Jaundice Neonatorum Fisologis di PKU Muhammadiyah 1 Yogyakarta (Disertasi). Yogyakarta: Universitas Aisyiyah

Tazami, R. M., Syah, S., & Jambi, U. 2013. Gambaran Faktor Risiko Jaundice Neonatorum pada Neonatus di Ruang Perinatologi RSUD Raden Mattaher Jambi: Cross Sectional. Jambi Medical Journal, 1(1):1-7.

Maisels, M. J., DeRidder, J. M., Kring, E. A., & Balasubramaniam, M. 2009. Routine Transcutaneous Bilirubin Measurements Combined with Clinical Risk Factors Improve the Prediction of Subsequent Hyperbilirubinemia. Journal of Perinatology, 29(9), 612–617. http://doi.org/10.1038/jp.2009.43

Suryandari , A. E., Agustina, E. E. 2013. Perbedaan Waktu Pemberian Kolostrum terhadap Kejadian Jaundice Fisiologis pada Bayi Baru Lahir Di RSU. Prof. Dr. Margono Soekarjo: Kohort. Involusi Jurnal Ilmu Kebidanan, 2, 1–12

Rohani, S., & Wahyuni, R. R. 2017. Jaundice Pada Neonatus. Ed With the Occurrence Neonates Jaundice, 2(1), 75–80.

Kramer, L. I. 1969. Advancement of Dermal Icterus in the Jaundiced Newborn. American Journal of Diseases of Children, 118(3), 454–458. http://doi.org/10.1001/archpedi.1969.02100040456007

Bobak, I. M., Lowdermilk, D. L., Jensen, M. D.2005. Buku Ajar Keperawatan Maternitas. Jakarta: EGC.

Haryono, R., Setianingsih, S. 2014. Manfaat ASI Eksklusif untuk Buah Hati Anda. Yogyakarta: Gosyen.

Hassan, B., & Zakerihamidi. M. 2018. The Correlation between Frequency and Duration of Breastfeeding and the Severity of Neonatal Hyperbilirubinemia. Journal of Maternal-Fetal and Neonatal Medicine, 31(4), 457–463. http://doi.org/10.1080/14767058.2017.1287897.

Ikatan Dokter Anak Indonesia [Indonesian Pediatric Society]. 2013. Manajemen laktasi. http://www.idai.or.id/artikel/klinik/asi/manajemen-laktasi


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