![]() The population we work with has been displaced by conflict or work in Thailand without any legal status their situation has become worse since the recent coup and any data pertaining to people on the border who have no legal status is therefore extremely sensitive. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: There are ethical restrictions on sharing data publicly and we do not have consent from participants for their data to be shared openly without any restrictions, and both Mahidol and Oxford Ethics Committees have agreed upon those terms. Received: MaAccepted: SeptemPublished: October 7, 2021Ĭopyright: © 2021 Thielemans et al. PLoS ONE 16(10):Įditor: Benedikt Ley, Menzies School of Health Research: Charles Darwin University, AUSTRALIA (2021) High levels of pathological jaundice in the first 24 hours and neonatal hyperbilirubinaemia in an epidemiological cohort study on the Thailand-Myanmar border. Given high levels of pathological jaundice in the first 24 hours and overall high NH burden, guidelines changes were implemented including preventive PT for all neonates <35 weeks and for those 35–37 weeks with risk factors.Ĭitation: Thielemans L, Peerawaranun P, Mukaka M, Paw MK, Wiladphaingern J, Landier J, et al. ![]() The risk of NH in Sgaw Karen refugees may be overlooked internationally as they are most likely regarded as Burmese in countries of resettlement. The genetic impact of G6PD deficiency on NH was partially interpreted by using the florescent spot test and further genotyping work is in progress. ![]() Risk factors for NH in the first week of life independent of gestational age were: neonatal G6PD deficiency, birth bruising, Sgaw Karen ethnicity, primigravidae, pre-eclampsia, and prolonged rupture of membranes. NH onset varied with gestational age: at a median 24 hours for neonates born 37 weeks or prematurely vs 59 hours for neonates born ≥38 weeks. One-quarter (26.3%) of NH occurred within 24 hours. Mortality from acute bilirubin encephalopathy was 10% (2/20) amongst the 5.3% (20/376) who reached the severe NH threshold. All neonates born <35 weeks, four in five born 35–37 weeks, and three in twenty born ≥38 weeks had NH, giving an overall incidence of 2 livebirths. Risk factors for developing NH were evaluated using Cox proportional hazard mixed model. Each neonate had total serum bilirubin measurements: scheduled (24, 48, 72 and 144 hours of life) and clinically indicated and weekly follow up until 1 month of age. Between January 2015 and May 2016, in a resource-limited setting on the Thailand-Myanmar border, neonates from 28 weeks’ gestation were enrolled into a prospective birth cohort. Knowledge of local risks permits interventions that may reduce the proportion becoming severe. Population risks for neonatal hyperbilirubinaemia (NH) vary.
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