الفهرس 
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Abstract
Neonatal hyperbilirubinemia is a common clinical problem encountered during the neonatal period, especially in the first week of life. Nearly 8% to 11% of neo-nates develop hyperbilirubinemia. When the total serum bilirubin (TSB) rises above the 95th per-centile for age (high-risk zone) during the first week of life, it will be considered as hyperbilirubinemia.
Several types of bilirubinemia have been reported in neonates including physiological jaundice, pathological jaundice, jaundice due to breastfeeding or breast milk and hemolytic jaundice including three subtypes due to Rh factor incompatibility, ABO blood group incompatibility and Jaundice associated with Glucose-6-phosphate dehydrogenase (G6PD) deficiency.
Hyperbilirubinemia can be treated easily without or with a minimal adverse effect with phototherapy. The efficacy of phototherapy depends on surface area exposed to phototherapy, double surface phototherapy may be more effective than single surface phototherapy. Spectrum of light source, Special blue tubes with the mark F20T12/BB should be used rather than F20T12/B lights and Irradiance or energy output may be increased in a phototherapy unit by lowering the distance of the neonate to within 15-20 cm.
Continuous phototherapy is better than intermittent phototherapy. Phototherapy should not be interrupted except during breast-feeding or nappy change
Fibrates have been used as a hypolipidemic drug for several years; it also enhances the bilirubin conjugation and excretion through induction of glucorunyl transferase activity. Most studies focused on the effect of fibrates on hyperbilirubinemia have been done with clofibrate. Clofibrate has been used for prophylaxis and treatment of hyperbilirubinemia in neonates at a dose of 100 mg/kg.
Although fenofibrate is the same as clofibrate in terms of the mechanism of action, it has fewer side effects than clofibrate, so it is much safer than clofibrate in the pediatric group. However, no side effects of fenofibrate have been observed by a single dose administration in the neonatal period.
The aim of the current study was to evaluate the use of fenofibrate in treatment of neonatal indirect hyperbilirubinemia.
A case control study was conducted on 80 neonates were randomly allocated to the control group (A) includes 30 full term neonates and fenofibrate group (B) contains other 50 full term neonates with the permission of their parents and the ethical committee of hospital.
Both groups were received phototherapy under stander conditions with 4 special white 420-480 nanometer lamp, adjusted to about 30 cm above the neonate.
All subjects were selected from neonatal ICU of Shebin El-Khom Teaching Hospital, Menoufia, Egypt from the period of March 2015 till April 2016. Clinical and laboratory data of the studied groups were tabulated and statistically analyzed.
Results of the current study was summarized as follow:
ABO incompatibility is a leading cause of neonatal jaundice. Males were affected more than females by neonatal jaundice.
Most of neonatal jaundice (28 cases, 56%) had weighted more than 3.00 kg and 22 (44%) neonatal jaundice had weighted less than 3.00 kg.
Most cases of fenofibrate group had blood group B, while most cases of control group had blood group AB.
There was statistically significant difference between fenofibrate and control groups regarding duration of stay in hospital.
Most cases of fenofibrate group stayed in hospital 5 days. While most of control group stayed in hospital 6 days.
There was non-significant difference between fenofibrate and control groups with neonatal hyperbilirubinemia regarding age, weight and total serum bilirubin.
There was a significant difference between fenofibrate and control groups with neonatal hyperbilirubinemia regarding plasma TSB values (mg/dl) after 72 hr from treatment.