• 대한한방소아과학회지
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• 제30권4호
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• pp.99-110
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• 2016

Introduction Jaundice is one of the most common conditions found in neonatal period. Phototherapy is one of the main treatments for neonatal jaundice. However, several adverse effects of the phototherapy have been reported, including DNA damage recently. Therefore, a variety of treatments have been conducted to shorten the duration of phototherapy. Meanwhile, it has been hardly tried to prevent neonatal jaundice, but diverse approaches have been tried in traditional Chinese medicine (TCM) for many years. Therefore, this study aims to analyze the studies for the treatments to prevent neonatal jaundice based on TCM. Materials and Methods Various literatures have been searched via CNKI, and PubMed using the terms "neonatal jaundice" (新生儿黄疸, 胎黃, 胎疸) in category of 'Traditional Chinese Medicine', 'Traditional Chinese Medicinal Herbs' and 'Combination of Traditional Chinese Medicine With Western Medicine'. The search range included randomized controlled trials (RCTs), controlled clinical trials (CCTs), case reports, reviews and animal experiments published from 2013 to 2015. Results A total of 104 studies were found. 93 articles were excluded by reviewing the titles and abstracts. Out of the remaining 11 studies, 9 articles were RCTs, 2 articles were CCTs. The treatment used in neonatal babies in the studies were, using herbal remedies (meditation 5, bath 3 and retention enema 1) and the acupressure. All treatments were initiated within the first 24-48 hours after their birth. Then, there was a study that the subjects taken the herbal medicine were women during pregnancy. The outcome assessments used were the serum total bilirubin (TB), transcutaneous bilirubin measurement (TCB), the incidence of the hyperbilirubinemia, the duration time of the jaundice. Especially, TB, TCB and the incidence of the hyperbilirubinemia have decreased significantly more than that of the control group in the most of the results. No severe adverse events were reported in all articles reviewed. Conclusions Conventional treatment such as, herbal medicine in TCM, seems to be the effective way to prevent neonatal jaundice or hyperbilirubinemia. Therefore, the conventional treatment may be favorable choice for preventive treatment for neonatal jaundice.

• Clinical and Experimental Pediatrics
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• 제63권1호
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• pp.8-13
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• 2020

Autism spectrum disorder is a common neurodevelopmental disorder with an unknown etiology. The correlation between neonatal jaundice and the risk of developing autism spectrum disorder was investigated previously. Some studies showed significant associations, whereas others demonstrated no association. In this meta-analysis, we pooled the results of observational studies to examine the association between neonatal jaundice and the risk of autism spectrum disorder among children. We identified all studies published through April 2018 by conducting a literature search using Web of Science, PubMed, and Scopus databases as well as the reference lists of the retrieved studies. The pooled odds ratios (ORs), rate ratio (RR), and their 95% confidence intervals (CIs) were calculated as random effect estimates of association among studies. We conducted a subgroup analysis to explore any potential sources of intergroup heterogeneity. The pooled estimates of OR and RR showed a considerable correlation between neonatal jaundice and ASD among children (OR, 1.35; 95% CI, 1.02-1.68) and (RR, 1.39; 95% CI, 1.05-1.74). A larger effect size was shown in the pooled estimated crude OR than in the adjusted OR (1.75 [0.96-2.54] vs. 1.19 [1.07-1.30]). This study showed that neonatal jaundice may be associated with ASD and may increase the risk of ASD among children.

• Clinical and Experimental Pediatrics
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• 제49권1호
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• pp.6-13
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• 2006

Jaundice is one of the most common gastrointestinal conditions found in neonatal period, and most jaundice is benign. But because of the possibility of bilirubin toxicity, every newborn infants must be examined to identify the development of severe hyperbilirubinemia. To prevent the development of severe hyperbilirubinemia, promote and support successful breast-feeding, perform a systemic assessment before discharge for the risk of severe hyperbilirubinemia, provide early and close follow-up program, and treat with phototherapy or exchange transfusion or other therapeutic modalities, if indicated, are recommended.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권sup2호
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• pp.35-43
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• 2008

Jaundice is common in breast-fed infants. Any infant noted to be jaundiced at 2 weeks of age need to be evaluated for cholestasis with measurement of total and direct serum bilirubin. The most common causes of cholestatic jaundice in infants are biliary atresia and neonatal hepatitis. Genetic causes of the neonatal hepatitis syndrome are increasingly recognized and idiopathic neonatal hepatitis is decreasing. Cholestasis should be investigated using a structured protocol. Early detection and timely, accurate diagnosis is important for successful treatment and a favorable prognosis. In particular, a Kasai portoenterostomy for biliary atresia has the best outcome if performed before the infant is 8 weeks of age. The management of cholestasis is mainly supportive, including nutritional support and alleviation of symptoms to improve the quality of life. Specific treatments are available for some causes of neonatal hepatitis syndrome and should be started as soon as possible. For decompensated liver disease, liver transplantation yields a better outcome.

• Child Health Nursing Research
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• 제27권4호
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• pp.377-384
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• 2021

Purpose: This study examined the effects of a breastfeeding coaching program for mothers on growth and neonatal jaundice in late preterm infants (LPIs). Methods: This was a quasi-experimental study (non-randomized intervention) with a time-series design. The study was conducted among 40 LPIs who were admitted to the neonatal intensive care unit of a university hospital in Daegu, South Korea. In the order of admission, the first 21 infants were assigned to the experimental group, and 19 were assigned to the control group. The intervention program consisted of home- based and web-based practical breastfeeding support education for mothers across a total of 5 sessions. Infant growth was measured using body weight, length, and head circumference, and neonatal jaundice was assessed using transcutaneous bilirubin levels. Results: The likelihood of breastfeeding for infants in the experimental group at 4 weeks after discharge was the same as on the day of discharge, whereas it steadily decreased in the control group. There were significant differences in head circumference between the groups. However, weight, length, and transcutaneous bilirubin levels did not show a significant group-time interaction. Conclusion: A formal breastfeeding coaching program should be considered in clinical settings and at home within the first few weeks postpartum.

• 대한핵의학회지
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• 제29권4호
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• pp.492-496
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• 1995

저자들은 신생아 황달에서 간담도 스캔의 결과를 판정하는데 있어서 간 섭취율의 차이가 담도폐쇄증과 신생아 간염 감별진단에 도움이 되는지 여부를 평가하고자 하였다. 1) 신생아 황달로 간담도 스캔을 시행한 38명의 환아중 24시간 지연 영상에서도 장내 방사능이 관찰되지 않은 14명중 확진된 결과를 얻을 수 있었던 13명의 환아를 대상으로 하였다. 2) 13명의 대상 환아중 담도폐쇄증이 4명, 신생아간염이 9명이었다. 3) 담도폐쇄증과 신생아 간염을 감별진단하는데 있어서 간 섭취율의 차이를 살펴본 결과 두 질환간의 통계적으로 의의있는 간 섭취율의 차이는 없었다. 4) 간담도 스캔은 장내 방사능의 유무로 두 질환을 감별시 민감도가 100%인 우수한 검사법이지만, 지연영상에서도 장내 방사능이 관찰이 안되는 경우에 대하여서는 Jaw등12)과 같이 십이지장액의 방사능을 측정하거나 또는 다른 보조적인 검사에 대한 연구가 필요하리라 생각된다.

• 대한수의학회지
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• 제51권1호
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• pp.55-58
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• 2011

Two 4-day-old Thoroughbred foals with acute clinical signs of depression, elevated pulse and respiratory rates, anemia, and jaundice were referred to the equine hospital of Korea Racing Authority. The foals were seemingly normal at birth, but showed clinical signs such as abnormal behavior, jaundice and anemia suddenly after ingestion of the mare's colostrum, followed by death at 4 days after birth. According to the results of the hematology, serum chemistry analysis, jaundice foal agglutination test, and blood groups test, the foals were diagnosed as neonatal isoerythrolysis (NI) caused by the mare's antibodies. These results suggested that the pregnant mares have a potential for NI.

• Clinical and Experimental Pediatrics
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• 제49권12호
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• pp.1296-1300
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• 2006

목 적 : 신생아 황달은 신생아기에 가장 흔한 질환으로 핵황달 및 사망까지의 심각한 후유증을 유발할 수 있기 때문에 신속하고 정확한 빌리루빈 농도의 측정과 치료가 중요하다. 따라서 신생아 황달의 진단에서 빌리루빈 측정법 중 경피적 빌리루빈 측정기의 개발로 신생아 황달의 선별법으로 사용되고 있다. 그러나 광선치료 동안에 경피적 빌리루빈 측정기의 유용성이 연구되지 않아 이에 저자들은 광선치료 동안에 측정하는 신체의 부위별 TcB와 PB의 상관관계를 조사해서 경피적 빌리루빈 측정기의 유용성을 알아보고자 본 연구를 시행하였다. 방 법 : 2005년 6월부터 8월까지 제일병원 신생아실에서 광선치료를 받는 황달의 임상적 위험성(미숙아, Rh및 ABO 부적합증, 간손상 등 다른 합병증)이 없는 신생아 90명을 대상으로 경피적 빌리루빈 측정기인 JM-103을 사용하여 광선치료 시작전 이마와 흉골 중앙부에 opaque patch을 붙이고 광선치료 동안에 opaque patch 부위와 바로 인접한 부위에서 TcB를 측정하였다. TcB 측정시 각각 3회씩 측정하여 평균치를 TcB로 하였으며, 경피적 빌리루빈 측정기로 측정한 시각으로부터 30분 이내에 발뒤꿈치를 천자하여 PB를 측정하여 측정 부위간 TcB와 PB의 상관관계를 비교 관찰하였다. 결 과 : 대상에 포함된 신생아는 황달의 임상적 위험성(미숙아, Rh 및 ABO 부적합증, 간손상 등 다른 합병증)이 없는 신생아를 대상으로 하였고 신생아의 평균 재태주령은 $38.6{\pm}1.3$주였고 평균 출생 체중은 $3,207.0{\pm}472.1g$이었고 광선치료 시작 시기는 평균 $4.9{\pm}0.9$일이고 평균 광선치료 기간은 $1.3{\pm}0.6$일이었다. 대상 신생아의 광선치료 시작전 PB와 patch 붙인 흉골 부위의 TcB, patch 붙인 이마 부위의 TcB, 흉골 부위의 TcB, 이마 부위의 TcB 결과는 각 부위간에 유의한 상관관계를 보였다. 광선치료 동안에 각 측정부위별(TcB-UF, TcB-UC, TcB-PF, TcB-PC)와 PB는 의미있는 상관관계를 나타내었고 opaque patch를 붙인 부위가 인접한 부위보다 PB와 의미 있는 상관관계를 나타내었으며 TcB-PC가 TcB-PF보다 더욱 더 PB와 의미 있는 상관관계를 나타내었으며 일치도가 높았다. 결 론 : 본 연구의 결과로 경피적 빌리루빈 측정기는 신생아 황달의 선별검사 방법뿐 아니라 광선치료 동안에도 추적검사 측정법으로 사용하기에 적절하다고 생각되며 사용하는 기관에서 자기고유의 회귀직선을 작성하여 사용한다면, 신생아의 몸에 침해를 가하지 않고 편리하고 신속하게 신생아 과빌리루빈혈증 진단과 추적검사에 유용하게 사용될 수 있으리라 생각된다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제14권2호
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• pp.122-129
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• 2011

The persistence of jaundice beyond the first 2 weeks of life require further investigation and this can be determined if the conjugated bilirubin levels are greater than 1.5 mg/dL or greater than 20% of the total bilirubin level. There is a diverse differential diagnosis for the cause of neonatal cholestasis due to hepatobiliary disease including biliary atresia, which eventually leads to liver cirrhosis if uncorrected before 60~80 days of life. Long-established initial studies include abdominal ultrasonography, hepatobiliary scintigraphy and liver biopsy, but better diagnostic methods are needed. Promising new options are described including MRCP (magnetic resonance cholangiography), ERCP (endoscopic retrograde cholangiography), and PCC (percutaneous cholecysto-cholangiography). Though no single test can differentiate biliary atresia from other neonatal cholestasis with confidence, a combination of diagnostic methods is usually consistently beneficial. By excluding biliary atresia as early as possible, the risk of unnecessary explolaparotomy with intraoperative cholangiography is decreased. Further evaluation would be required for the diagnosis of neonatal cholestasis after excluding biliary atresia.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권5호
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• pp.453-459
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• 2019

Purpose: Jaundice accounts for most hospital admissions in the neonatal period. Nowadays, in addition to phototherapy, other auxiliary methods are used to reduce jaundice and the length of hospitalization. This study aimed to investigate the effect of probiotics on the treatment of hyper-bilirubinemia in full-term neonates. Methods: In this randomized clinical trial, 83 full-term neonates, who were admitted to the hospital to receive phototherapy in the first 6 months of 2015, were randomly divided into two groups: synbiotic (SG, n=40) and control (CG, n=43). Both groups received phototherapy but the SG also received 5 drops/day of synbiotics. Serum bilirubin, urine, stool, feeding frequency, and weight were measured daily until hospital discharge. A p-value<0.05 was considered statistically significant. Results: The mean total serum bilirubin in the SG was lower than that in the CG ($9.38{\pm}2.37$ and $11.17{\pm}2.60mg/dL$, respectively). The urine and stool frequency in the SG was significantly higher than that in the CG (p<0.05). The duration of hospitalization in the SG was shorter than that in the CG. Conclusion: Use of synbiotics as an adjuvant therapy had a significant treatment effect on jaundice in full-term neonates. Further studies including larger samples with long follow-up periods are essential to confirm the benefits of routine use of synbiotics in neonatal patients with jaundice.