Abstract
Background: Acute bilirubin encephalopathy (ABE) is an important cause of neonatal morbidity in Nigeria, accounting for 5–14% of neonatal deaths. Most newborns with severe ABE have irreversible damage before receiving treatment emphasizing the need for timely pre-admission monitoring and referral. There is limited evidence that educational interventions targeting mothers and health care providers will reduce delayed care. Objective: To provide baseline data on the incidence of ABE and associated pre-admission risk factors in five centers of Nigeria in order to evaluate the effect of subsequent educational interventions on outcome. Study design: The incidence of ABE among newborns treated for hyperbilirubinemia was documented prospectively. Bivariate analysis and multivariate logistic regression were used to evaluate risk factors for acute bilirubin encephalopathy and reasons for regional differences in its occurrence. Results: Of 1040 infants, 159 treated for hyperbilirubinemia (15.3%) had mild to severe bilirubin encephalopathy (including 35 deaths), but the incidence ranged from 7 to 22% between centers. Logistic regression identified four common predictors: total serum bilirubin (odds ratio 1.007 per mg/dl rise), out-of-hospital births (OR 2.6), non-alloimmune hemolytic anemia (OR 2.8), and delayed care seeking (OR 4.3). Conclusion: The high occurrence of bilirubin encephalopathy in Nigeria is due in large part to a delay in seeking care. A planned intervention strategy will target conditions leading to severe hyperbilirubinemia and delay.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 873-880 |
| Number of pages | 8 |
| Journal | Journal of Perinatology |
| Volume | 38 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jul 1 2018 |
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PubMed: MeSH publication types
- Journal Article
- Multicenter Study
- Research Support, Non-U.S. Gov't
- Research Support, U.S. Gov't, Non-P.H.S.
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Patterns of acute bilirubin encephalopathy in Nigeria : a multicenter pre-intervention study. / *On behalf of the Stop Kernicterus In Nigeria (SKIN) study group.
In: Journal of Perinatology, Vol. 38, No. 7, 01.07.2018, p. 873-880.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Patterns of acute bilirubin encephalopathy in Nigeria
T2 - a multicenter pre-intervention study
AU - On behalf of the Stop Kernicterus In Nigeria (SKIN) study group
AU - Diala, Udochukwu M.
AU - Wennberg, Richard P.
AU - Abdulkadir, Isa
AU - Farouk, Zubaida L.
AU - Zabetta, Carlos D.Coda
AU - Omoyibo, Efe
AU - Emokpae, Abieyuwa
AU - Aravkin, Aleksandr
AU - Toma, Bose
AU - Oguche, Stephen
AU - Slusher, Tina
PY - 2018/7/1
Y1 - 2018/7/1
N2 - Background: Acute bilirubin encephalopathy (ABE) is an important cause of neonatal morbidity in Nigeria, accounting for 5–14% of neonatal deaths. Most newborns with severe ABE have irreversible damage before receiving treatment emphasizing the need for timely pre-admission monitoring and referral. There is limited evidence that educational interventions targeting mothers and health care providers will reduce delayed care. Objective: To provide baseline data on the incidence of ABE and associated pre-admission risk factors in five centers of Nigeria in order to evaluate the effect of subsequent educational interventions on outcome. Study design: The incidence of ABE among newborns treated for hyperbilirubinemia was documented prospectively. Bivariate analysis and multivariate logistic regression were used to evaluate risk factors for acute bilirubin encephalopathy and reasons for regional differences in its occurrence. Results: Of 1040 infants, 159 treated for hyperbilirubinemia (15.3%) had mild to severe bilirubin encephalopathy (including 35 deaths), but the incidence ranged from 7 to 22% between centers. Logistic regression identified four common predictors: total serum bilirubin (odds ratio 1.007 per mg/dl rise), out-of-hospital births (OR 2.6), non-alloimmune hemolytic anemia (OR 2.8), and delayed care seeking (OR 4.3). Conclusion: The high occurrence of bilirubin encephalopathy in Nigeria is due in large part to a delay in seeking care. A planned intervention strategy will target conditions leading to severe hyperbilirubinemia and delay.
AB - Background: Acute bilirubin encephalopathy (ABE) is an important cause of neonatal morbidity in Nigeria, accounting for 5–14% of neonatal deaths. Most newborns with severe ABE have irreversible damage before receiving treatment emphasizing the need for timely pre-admission monitoring and referral. There is limited evidence that educational interventions targeting mothers and health care providers will reduce delayed care. Objective: To provide baseline data on the incidence of ABE and associated pre-admission risk factors in five centers of Nigeria in order to evaluate the effect of subsequent educational interventions on outcome. Study design: The incidence of ABE among newborns treated for hyperbilirubinemia was documented prospectively. Bivariate analysis and multivariate logistic regression were used to evaluate risk factors for acute bilirubin encephalopathy and reasons for regional differences in its occurrence. Results: Of 1040 infants, 159 treated for hyperbilirubinemia (15.3%) had mild to severe bilirubin encephalopathy (including 35 deaths), but the incidence ranged from 7 to 22% between centers. Logistic regression identified four common predictors: total serum bilirubin (odds ratio 1.007 per mg/dl rise), out-of-hospital births (OR 2.6), non-alloimmune hemolytic anemia (OR 2.8), and delayed care seeking (OR 4.3). Conclusion: The high occurrence of bilirubin encephalopathy in Nigeria is due in large part to a delay in seeking care. A planned intervention strategy will target conditions leading to severe hyperbilirubinemia and delay.
UR - http://www.scopus.com/inward/record.url?scp=85044474312&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85044474312&partnerID=8YFLogxK
U2 - 10.1038/s41372-018-0094-y
DO - 10.1038/s41372-018-0094-y
M3 - Article
C2 - 29593357
AN - SCOPUS:85044474312
VL - 38
SP - 873
EP - 880
JO - Journal of Perinatology
JF - Journal of Perinatology
SN - 0743-8346
IS - 7
ER -