Ogunlesi T A, Dedeke I O F, Adekanmbi A F, Fetuga M B, Ogunfowora O B
Department of Paediatrics, Olabisi Onabanjo University, Sagamu, Nigeria.
Niger J Med. 2007 Oct-Dec;16(4):354-9.
To determine the current trends in the incidence and outcome of bilirubin encephalopathy among Nigerian babies.
A review of the hospital records of babies managed for bilirubin encephalopathy at the Wesley Guild Hospital (WGH), Ilesa and Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu, both in southwest Nigeria between 2001 and 2005 was carried out. The age, sex, weight, body temperature on admission, place of delivery and outcome of hospitalization were studied. The fatal cases and the survivors were compared for risk factors for mortality.
Fifty eight (3.4%) and 57 (2.3%) babies had bilirubin encephalopathy out of 1706 and 2492 total neonatal admissions at OOUTH and WGH respectively. Of these 115 babies, 3 (2.6%), 84 (73.0%) and 28 (24.3%) were aged <3 days, 3-6 days and 7 days or more. Sixty eight (59.1%) babies were delivered in orthodox health facilities. Aside clinically suspected cases of G6PD deficiency, ABO incompatibility and septicaemia were commonly associated with bilirubin encephalopathy, Forty four (38.3%), 36 (31.3%) and 35 (30.4%) had Unconjugated bilirubin of <340 micromol/L, 341-425 micromol/L and >425 micromol/L respectively Sixty eight (59.1%) were discharged, 42 (36.5%) died while 5 (4.7%) were discharged against medical advice. Prematurity, low birth weight, severe anaemia and inability to do Exchange Blood Transfusion were significant risk factors for mortality among babies with bilirubin encephalopathy. Cerebral palsy, seizure disorders and deafness were the leading neurological sequelae (86.4%, 40.9% and 36.4% respectively) among the 22 survivors who were followed up.
Bilirubin encephalopathy remains a common clinical finding in Nigeria and the associated mortalities and neurological sequelae are significant.
确定尼日利亚婴儿胆红素脑病的发病率及转归的当前趋势。
对2001年至2005年间在尼日利亚西南部伊莱萨的卫斯理公会医院（WGH）和萨加穆的奥拉比西·奥纳班乔大学教学医院（OOUTH）接受胆红素脑病治疗的婴儿的医院记录进行回顾。研究了婴儿的年龄、性别、体重、入院时体温、分娩地点及住院转归。比较了死亡病例和存活者的死亡危险因素。
OOUTH和WGH的新生儿总入院数分别为1706例和2492例，其中分别有58例（3.4%）和57例（2.3%）婴儿患有胆红素脑病。在这115例婴儿中，年龄＜3天、3 - 6天和7天及以上的分别有3例（2.6%）、84例（73.0%）和28例（24.3%）。68例（59.1%）婴儿在正规卫生机构分娩。除临床疑似葡萄糖-6-磷酸脱氢酶（G6PD）缺乏症病例外，ABO血型不合和败血症常与胆红素脑病相关，分别有44例（38.3%）、36例（31.3%）和35例（30.4%）的未结合胆红素＜340微摩尔/升、341 - 425微摩尔/升和＞425微摩尔/升。68例（59.1%）出院，42例（36.5%）死亡，5例（4.7%）违反医嘱出院。早产、低出生体重、严重贫血及无法进行换血治疗是胆红素脑病婴儿死亡的重要危险因素。在接受随访的22例存活者中，脑瘫、癫痫障碍和耳聋是主要的神经后遗症（分别为86.4%、40.9%和36.4%）。
胆红素脑病在尼日利亚仍是常见的临床病症，相关死亡率及神经后遗症较为严重。
