Introduction: Hyperbilirubinemia is a relatively common disorder among infants in Iran. Bacterial infection and jaundice may be associated with higher morbidity. Previous studies have reported that jaundice may be one of the signs of infection. The aim of this study was to determine the incidence rate, presentation time, severity of jaundice, signs and complications of infection within Neonatal Hyperbilirubinemia.Materials and Methods: This cross sectional study was conducted between 2003 and 2011, at Ghaem Hospital, Mashhad- Iran. We prospectively evaluated 1763 jaundiced newborns. We finally found 434 neonates who were categorized into two groups.131 neonates as case group (Blood or/and Urine culture positive or sign of pneumonia) and 303 neonates with idiopathic jaundice as control group. Demographic data including prenatal, intrapartum, postnatal events and risk factors were collected by questionnaire. Biochemical markers including bilirubin level, urine and blood cultures were determined at the request of the clinicians.Results: Jaundice presentation time, age on admission, serum bilirubin value and hospitalization period were reported significantly higher among case group in comparison with control group (p<0.0001). Urinary tract infection (UTI), sepsis and pneumonia were detected in 102 (8%), 22 (1.7%) and 7 (0.03%) cases, respectively.Conclusion: We concluded that bacterial infection was a significant cause of unexplained Hyperbilirubinemia among jaundice newborns (10%). Therefore, we advise performing screening test for UTI as part of the evaluation in asymptomatic jaundice infants presenting after five days of life and sepsis workup should be request in symptomatic infant especially in the first week of life.

Background: Neonatal jaundice is a common problem that can result in serious neurological side effect such as Kern icterus. Several drugs are used to prevent Neonatal jaundice. The effect of clofibrate in the prevention of Hyperbilirubinemia in healthy term neonates has not been paid attention to. This study aimed to evaluate the preventive effect of clofibrate on Neonatal jaundice in term neonates.Methods: This clinical trial was conducted on 80 healthy newborns randomly divided in to cases and control groups. The case group received clofibrate (50 mg/kg of body weight) orally in the first hour after birth and after the first period of breastfeeding. Serum bilirubin levels were measured in cord blood and again at 24, 48 and 72 hours after birth in both groups and were compared.Babies with clear jaundice on the first day, direct Neonatal jaundice>1 mg/dl, sick infants, and infants of mothers treated with phenobarbital and preterm infants weighing less than 2500 gr were excluded.Results: The mean bilirubin level in cord blood and its level at 24, 48 and 72 hours after birth in control groups were 1.99±0.46, 2.88±0.88, 5.94±1.15, 7.65±1.69, respectively and in the case group were 2.12±0.75, 2.89±0.95, 5.8±1.16, 7.18±1.57, respectively. Thus, the mean bilirubin in the case group is lower, but it was not statistically significant. Also, sex distribution, Rh-blood group incompatibility and G6PD deficiency in both groups showed no significant difference.Conclusions: Our results showed that prophylactic clofibrate application reduced Neonatal Hyperbilirubinemia, but wasn’t statistically significant.

Background: Newborn infants who are risk for severe Hyperbilirubinemia and cared at home should be monitored for progression of jaundice. We aimed to verify if a smart phone application (BiliScan Inc), which uses automated imaging for bilirubin (AIB), can be used to estimate total serum bilirubin (TSB) levels at home. Methods: A convenience sample of 1038 “ healthy” infants in China were prospectively enrolled to a singlecenter study in 2016. Correlations between AIB and TcB measurements were correlated to TB measurements. Bias and imprecision of AIB measurements were determined using Bland-Altman analysis. The diagnostic value of AIB was compared by the area-under-curve (AUC) values of receiver operator characteristic (ROC) curves. Results: The best correlation and AUC for AIB were at the sternum, both with values of 0. 76. We truncated performances to 369 TB values >5 and <15 mg/dL, and sternal AIB showed the best correlation to TB (r =0. 5, P<0. 0001). The AUC for this range was 0. 54. However, from a subset of 200 AIB values >13. 5 mg/dL (n=369 babies), the sensitivity and negative predictive value (NPV) were 100% with a specificity of 50%. Furthermore, Bland-Altman analyses showed a bias and imprecision of AIB and TcB when TB was >13. 5 and <15 mg/dL. Conclusion: The use of AIB may be a potentially useful screening device for Neonatal jaundice. Its performance requires additional improvements for accurate measurements across wider ranges of TB levels.

Background: Jaundice is affecting over 60-80 percent of neonates in the first week of life. Glucose-6-phosphate dehydrogenase (G6PD) deficiency, which is an important cause of pathologic Hyperbilirubinemia, can lead to hemolytic anemia, jaundice and kernicterus. The present study was performed to determine the prevalence of G6PD deficiency among icteric neonates in Shirvan, Iran.Methods: This descriptive, analytical study was performed by evaluating the medical records of neonates with jaundice, admitted to the Neonatal ward of Imam Khomeini Hospital of Shirvan in 2012-2013. All neonates, who were evaluated in terms of G6PD, were included in this study. Data including the clinical signs and symptoms, laboratory test results and maternal history during pregnancy were recorded in the questionnaires. The patients were divided into two groups: with and without G6PD deficiency. The recorded data were compared between the two groups, using t-test and Chi-square test. P-value less than 0.05 was considered statistically significant.Results: Among 452 admitted neonates, 16 (3.5%) presented with G6PD deficiency. There was no significant difference between the two groups in terms of birth weight, weight on admission, Coombs’ test results, hematocrit level, length of hospital stay and total bilirubin level. However, there was a significant difference between the two groups regarding reticulocyte count.Conclusion: Based on the findings, establishment of an early G6PD screening program, which can prevent further complications in neonates, seems essential, particularly in countries such as Iran where G6PD deficiency is highly prevalent.