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Original Article
Neonatology (Perinatology)
Does anaesthesia in mothers during delivery affect bilirubin levels in their neonates?
Zeinab A El-Kabbany, Nadin N Toaima, Tamer N Toaima, Mona Y Gamal EL-Din
Clin Exp Pediatr. 2017;60(12):385-389.   Published online December 22, 2017

This study aimed to assess whether different anesthetic techniques and oxytocin use applied during delivery affect transcutaneous bilirubin levels during the first 24 hours in neonates.


A total of 1,044 neonates delivered by either caesarian section (C/S) or normal vaginal delivery (NVD) were included in the study. They were classified into 5 groups as follows: group 1: born by C/S using...

Genetics and Metabolism
Neonatal indirect hyperbilirubinemia and glucose-6-phosphate dehydrogenase deficiency
Hasan M. Isa, Masooma S. Mohamed, Afaf M. Mohamed, Adel Abdulla, Fuad Abdulla
Clin Exp Pediatr. 2017;60(4):106-111.   Published online April 25, 2017

This study aimed to determine the prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency among infants with neonatal indirect hyperbilirubinemia (NIH); compare G6PD-deficient and G6PD-normal patients regarding hyperbilirubinemia and need for exchange transfusions (ET); and assess risk factors for ET and kernicterus.


This is a case-control retrospective study. Medical records of NIH patients admitted to the Pediatric Department, Salmaniya Medical Complex, Bahrain, between...

Glutathione S-transferase polymorphism of neonatal hyperbilirubinemia in Korean neonates
Chang Seok Kang, Seung Su Hong, Ji Sook Kim, Eun Ryoung Kim
Clin Exp Pediatr. 2008;51(3):262-266.   Published online March 15, 2008
Purpose : Glutathione S-transferase (GST) is a polymorphic supergene family of detoxification enzymes that are involved in the metabolism of numerous diseases. Several allelic variants of GSTs show impaired enzyme activity and are suspected to increase the susceptibility to diseases. Bilirubin is bound efficiently by GST members. The most commonly expressed gene in the liver is GSTM1, and GSTT1 is...
The relationship between Gly71Arg and TATA box polymorphism of UGT1A1 gene and prolonged hyperbilirubinemia of breast milk feeding infant in Korean
Jae Myoung Lee, Young Ji Han, Ji Sook Kim, Eun Ryoung Kim
Clin Exp Pediatr. 2008;51(2):150-155.   Published online February 15, 2008
Purpose : It has been known that breast milk cause prolonged unconjugated hyperbilirubinemia. UGT1A1 is a important gene of uridine diphosphate glucuronosyltransferase (UGT) which has a major role of bilirubin metabolism. These findings suggest that there is a relationship between UGT1A1 gene mutation and prolonged jaundice of breast feeding infant. The aim of study was to investigate whether a polymorphism...
Clinical factors causing hyperbilirubinemia in patients with Kawasaki disease
Kyung Hee Moon, Ok Ran Kim, Seung Taek Yu, Myung Eun Hong, Chang Woo Lee, Du Young Choi, Yeon Kyun Oh, Jong Duk Kim, Hyang Suk Yoon
Clin Exp Pediatr. 2007;50(1):52-55.   Published online January 15, 2007
Purpose : Hyperbilirubinemia, jaundice and gallbladder hydrops are unusual manifestations of Kawasaki disease (KD). In this case, abdominal pain, anorexia and abdominal distension may follow eventfully. We reviewed the clinical and laboratory data to investigate the causative factors of hyperbilirubinemia in patients with KD. Methods : Two-hundred eighty two children diagnosed and hospitalized with KD were identified by searching patients' charts....
The relation between angiotensin converting enzyme (ACE) gene polymorphism and neonatal hyperbilirubinemia in Korea
Mi Yeoun Kim, Jae Myoung Lee, Ji Sook Kim, Eun Ryoung Kim, Hee Jae Lee, Seo Hyun Yoon, Joo Ho Chung
Clin Exp Pediatr. 2007;50(1):28-32.   Published online January 15, 2007
Purpose : Human angiotensin converting enzyme (ACE) gene shows an insertion/deletion polymorphism in 16 intron, and three genotypes are determined by whether a 287 bp fragment of the DNA is present or not; II, ID and DD genotype. DD genotype has been suggested as a risk factor of chronic nephrotic disease such as IgA nephropathy and diabetic nephropathy, various cardiovascular...
1828G>A polymorphism of the UDP-glucuronosyltransferase gene (UGT1A1) for neonatal hyperbilirubinemia in Koreans
Ja Young Kim, Mi Yeoun Kim, Ji Sook Kim, Eun Ryoung Kim, Seo Hyun Yoon, Hee Jae Lee, Joo Ho Chung
Clin Exp Pediatr. 2006;49(1):34-39.   Published online January 15, 2006
Purpose : The incidence of neonatal hyperbilirubinemia is twice as high in East Asians as in Caucasians. However, its metabolic basis has not been clearly explained. The UDP-glucuronosyltransferase gene(UGT1A1) mutation was found to be a risk factor of neonatal hyperbilirubinemia. We studied whether neonatal hyperbilirubinemia is associated with the 1828G>A(rs 10929303) polymorphism of the UGT1A1 gene, which encodes for a...
Etiology, Management, and Prognosis of Severe Hyperbilirubinemia (Serum Bilirubin Level=25 mg/dL) in Newborn
Jong Hee Hwang, Ji Hyun Lee, Yu Jin Kim, Su Hyun Koo, Jang Hun Lee, Chang Won Cho, Yun Sil Chang, Won Soon Park
Clin Exp Pediatr. 2005;48(10):1102-1106.   Published online October 15, 2005
Purpose : The present study examined the etiology, management, and the difference of prognosis according to methodology of treatment in severe hyperbilirubinemia with total serum bilirubin levels of more than 25 mg/dL. Methods : Medical records of severe hyperbilirubiemia in newborns(serum level=25 mg/dL) admitted to the NICU of Samsung Medical Center between October 1994 and June 2004 were reviewed retrospectively. Infants...
Near-Infrared Spectroscopy for Monitoring Cerebral Hemodynamics in Hyperbilirubinemia-induced Newborn Piglets
Jong Hee Hwang, Chang Won Choi, Yun Sil Chang, Won Soon Park
Clin Exp Pediatr. 2005;48(6):649-654.   Published online June 15, 2005
Purpose : The present study examined how changes in cerebral hemodynamics in newborn piglets with bilirubin infusion can be evaluated by near infrared sepctroscopy(NIRS). Methods : Seventeen newborn piglets were randomly divided into the following three experimental groups : six in the control group(CG); seven in the bilirubin infusion group(BG), and four in the bilirubin infusion with 7-nitroindazole group(NG). To...
The Association of Neonatal Hyperbilirubinemia with UGT1A1 and CYP1A2 Gene Polymorphism in Korean Neonates
Hoon Kang, Jun Ho Lim, Ji Sook Kim, Eun Ryoung Kim, Sung Do Kim, Hee Jae Lee, Joo Ho Chung
Clin Exp Pediatr. 2005;48(4):380-386.   Published online April 15, 2005
Purpose : The incidence of nonphysiologic neonatal hyperbilirubinemia is twice as high in East Asians as in whites. Recently, UGT1A1 mutation was found to be a risk factor for neonatal hyperbilirubinemia. In congenitally-jaundiced Gunn rats, which lack expression of UDP-glucuronosyltransferase, alternative pathways can be stimulated by inducers of CYP1A1 and CYP1A2 enzymes. CYP1A2 plays a major role in bilirubin degradation...
Case Report
Two Cases of Rotor Syndrome in Siblings
Hwa-Jin Park, Eun-Sung Kim, Ji-Young Chung, Sung-Ho Cha, Deog-Yoon Kim
Clin Exp Pediatr. 2004;47(8):892-895.   Published online August 15, 2004
Rotor syndrome is a rare benign familial disorder characterized by chronic, fluctuating, nonhemolytic and predominantly direct bilirubinemia with normal liver tissue. We have recently experienced two cases of Rotor syndrome in a brother and sister. They revealed icteric sclerae with mild hepatomegaly in physical examination. Laboratory findings showed increased serum bilirubin with direct bilirubin predominance. The urinary excretion of total...
Original Article
Polymorphism of UDP-glucuronosyltransferase Gene(UGT1A1) of Neonatal Hyperbilirubinemia in Korea
Ki Woong Hong, Hoon Kang, Soo Kim, Ji Sook Kim, Eun Ryoung Kim, Hee Jae Lee, Sheng-Yu Jin, Joo Ho Chung
Clin Exp Pediatr. 2004;47(1):18-23.   Published online January 15, 2004
Purpose : The incidence of neonatal hyperbilirubinemia is twice as high in East Asians as in whites and its metabolic basis has not been clearly explained. Recently, UDP-glucuronosyltransferase gene (UGT1A1) mutation was found to be a risk factor of neonatal hyperbilirubinemia in Japanese and Taiwanese Chinese. We studied whether neonatal hyperbilirubinemia is associated with mutation of UGT1A1, which is a...
Diurnal Variation in Serum Bilirubin Concentration of Normal Newborn Infant
Cheol Am Kim, Jin Geong Jeong, Eui Tak Oh, Hong Ja Gang, Gil Seu Kim
Clin Exp Pediatr. 1998;41(1):33-37.   Published online January 15, 1998
Purpose : We investigated whether there are independent intradaily changes in bilirubin levels in normal neonates. Methods : During the period of January 1996 till July 1996, 100 healthy newborn infants were studied for at least 3 consecutive days. Starting from the third day of life, consistent intradaily changes of bilirubin concentration were observed. And obstetric history, birth history, weight change at 3 days were...
Oral Agar and Conventional Phototherapy Combination in the Treament of Neonatal Hyperbilirubinemia
Seong Wha Kim, Ji Hyang Doh, Jin Woo Choi, Min Hyang Kim, Ji Won Lee, Sung Taek Kim
Clin Exp Pediatr. 1997;40(7):931-938.   Published online July 15, 1997
Purpose : Neonatal jaundice is one of the most common problems in our country leading to hospitalization. Agar is low cost, low risk, and easily fed orally; it can bind bilirubin in the intestine, decreasing its enterohepatic circulation, thereby decreasing serum bilirubin levels. At present, however, the effectiveness of agar in the prevention and treament of neonatal jaundice is quite conflicting and controversy. Recently we...
Comparison of The Efficacy of the Fiberoptic Phototherapy and Conventional Phototherapy for Neonatal Hyperbilirubinemia
Hye Jung Min, Gwi Sook Kim, Soo Kyung Lee, Il Kyung Kim, Ho Sung, Chang Hee Choi
Clin Exp Pediatr. 1996;39(8):1076-1083.   Published online August 15, 1996
Purpose : We performed this study in order to compare the feasibility and efficacy of the fiberoptic phototherapy with conventional phototherapy and double phototherapy with single phototherapy for the treatment of neonatal hyperbilirubinemia while watching for any possible side effects of the system. Methods : During the period of February 1994 till June 1995, randomized controlled study was performed. 130 healthy term infants with non-hemolytic...
A Study of Auditory Brainstem Responses in Neonates with Hyperbilirubinemia and Their Neurodevelopmental Outcome
Sung Shin Park, Myoung Jae Chey, Kil Hyun Kim, Hak Soo Lee
Clin Exp Pediatr. 1995;38(1):1-9.   Published online January 15, 1995
Neonatal hyperbilirubinemia is a significant risk factor for the developemtn of otoneurologic disorder. Hyperbilirubinemia resulting in kernicterus produces widespread neuronal damage with the most common sites of staining and destruction involving the hippocampus, basal ganglia and the brainstem nuclei in the floor of the fourth ventricle, including the dorsal cochlear nucleus. ABR may be a useful tool for the monitoring early...
A Clinical Observation of Neonatal Hyperbilirubinemia Due to ABO imcompatibility
Kang Woo Lee, Young Guk Kim, Dong Gun Park, Kee Hwan Yoo, Kwang Chul Lee, Soon Kyum Kim
Clin Exp Pediatr. 1994;37(1):54-60.   Published online January 15, 1994
A clinical and statistical study was performed on 213 neonates of hyperbilirubinemia who were admitted to department of pediatrics of Korea University Hospital from Jan. 1989 to Jun. 1991. And we studied the difference between ABO compatible group and incompatible group, such as, day of appe5rance of hyperbilirubinemia, tendency of bilirubin concentration change, reticulocyte, hemoglobin and duration of hyperbilirubinemia. The following...
High-Dose Intravenous Immune Globulin Therapy for Hyperbilirubinemia Caused by ABO Incompatibility
Dong Sung Kim, Dong Un Kim, Ji Whan Han, Sung Soo Whang, Kyung Yil Lee, Man Kyu Yang
Clin Exp Pediatr. 1993;36(8):1073-1079.   Published online August 15, 1993
Four newborn infants with hyperbilirubinemia, caused by ABO blood group incompatibility, were treated with high-dose intravenous immune globulin (IVIG). As soon as the diagnosis was clinically suspected, these infants received conventional treatment including phototherapy and were monitored closely for bilirubin levels. When bilirubin concentrations reached the risk point in spite of pjototherapy, IVIG was given at a dose of 1g/kg for...
Changes in Auditory Brainstem Reponses (ABR) in Severe Hyperbilirubinemic Neonates with Transient Bilirubin Encephalopathy.
Chong Woo Bae, Sa Jun Chung, Chang Il Ahn
Clin Exp Pediatr. 1990;33(9):1216-1222.   Published online September 30, 1990
Many authors have reported alterations in the ABR in severe hyperbilirubinemia and ABR is an effective non-invasive method of assessing the functional status of the auditory nerve and brainstem sensory pathway in the management of neonatal hyperbilirubinemia. Perlman et al reported that jaundice in the early neonatal period is associated with significant transient aberration of ABR, suggestive of a transient bilirubin encephalopathy (TBE). And...
A Clinical Observation of Neonatal Hyperbilirubinemia due to ABO Incompatibility.
Mi Jung Koh, Young Kyun Lee, Jin Hong Park, Yeon Kyun OH
Clin Exp Pediatr. 1990;33(9):1194-1201.   Published online September 30, 1990
A clinical and statistical study was performed on 43 neonates of hyperbilirubinemia due to ABO incompatibility who were admitted to department of pediatrics of Won-kwang University hospital from May 1987 to June 1988. The following results were obtained: 1) The incidence of hyperbilirubinemia within 48 hrs were 30.3% in the incompatible group and 10. 2% in the compatible group. So, hyperbilirubinemia was appeared earlier in...
Measurement of Carboxyhemoglobin in the Newborns with ABO Incompatible Hyperbilirubinemia.
Jung Ae Shin, Son Moon Shin, Jeong Ok Hah, Chun Dong Kim
Clin Exp Pediatr. 1990;33(9):1188-1193.   Published online September 30, 1990
To develop more reliable screening test for ABO incompatible hemolytic disease than commonly employed and to identify possible indicators of severity of hyperbilirubinemia, a pilot study was performed by measuring the carboxyhemoglobin (HbCO) of the newborn babies within 48 hours after birth. Forty eight newborn babies were studied and carboxyhemoglobin was measured by spectro- photometry and serum bilirubin was measured by Diazo coupling method. There...
Two Case of Transient Bilirubin Encephalopathy in Newborn.
Eun Kyoung Sohn, Chong Woo Bae, Sa Jun Chung, Chang Il Ahn
Clin Exp Pediatr. 1989;32(9):1295-1299.   Published online September 30, 1989
More recently, several studies have been repotted about the abnormalities of auditory brainstem response (ABR) in hyperbilirubinemia of newborn. By using of ABR, visual evoked potenital and nuclear magnetic resonance techniques, some investigators suggested that transient alteration in ABR in severely jaundiced neonates indicated reversible transient subclinical or clinical bilirubin induced neurotoxicity. They thought it would be the early stage of kernicterus. We experienced two...
A Study of Milk β-Glucuronidase Activity in Breast Milk Associating with Neonatal Jaundice.
Soo Chun Kim, Chong Woo Bae, Yong Mook Choi, Chang Il Ahn
Clin Exp Pediatr. 1989;32(9):1202-1209.   Published online September 30, 1989
Since the 1960s, several reports have been presented to explain how the ingestion of human milk is related to neonatal jaundice. Recently, the jaundiced neonates whose mother’s milk contain sub- stances (eg, pregnane 3a, 20β-diol, lipoprotein lipase, free fatty acid, β-glucuronidase etc) facilitating the reabsorption of unconjugated bilirubin in the neonatal intestine through the enhancement of the enterohepatic circulation, were called the breast milk...
Acid-Base and Electrolyte Change Before and After Exchange Transfusion with ACD-B Blood in Hyperbilirubinemia of Newborn.
Ki Hong Park, Chong Woo Bae, Yong Mook Choi, Chang Ill Ahn, Jung Kook Lee
Clin Exp Pediatr. 1989;32(3):311-320.   Published online March 31, 1989
Exchange transfusion is being used widely to correct anemia and control existing hyperbilirubinemia for the prevention of kernicterus in newborn. But the blood used for exchange transfusion is stored blood containing anticoagulants and other substances. So many metabolic changes can be developed after exchange transfusion. This study was undertaken to evaluate the acid-base and electrolyte change after exchange transfusion using the ACD-B blood. In...
A Case of Hemolytic Disease of Newborn due to Anti-E.
Sang Keun Oh, Youn O Park, hyun Sook Seo, Mi Sook Park, Young Chul Lee, Hee Dae Park, Hee Joo Lee
Clin Exp Pediatr. 1988;31(8):1059-1063.   Published online August 31, 1988
A 2-day-old male infant was admitted to the Incheon Christian Hospital due to severe jaundice. He was a third baby and his Rh phenotype was CcDEe. The direct antiglobulin test of the infant was strong positive. Eluates that were made from the infanfs elder brother and sister were both CDe. Her two previous infants showed no evidence of erythroblastosis. She had a past...
Changes in Auditory Brainstem Resposes in Hyperbilirubinemic Neonates Before and after Exchange Transfussion and Phototherapy.
Chong Woo Bae, Young Ho Ra, Sa Jun Chung, Chang Il Ahn
Clin Exp Pediatr. 1988;31(5):547-554.   Published online May 31, 1988
More recently, several studies of newborns involving ABR testing have demonstrated abnormalities following an exposure to moderate or severe hyperbilirubinemia. Jaundice in the early neonatal period is associated with significant transient aberrations of ABR, which suggested transient brain- stem encephalopathy. So, many authors mentioned that ABR may be a useful tool for the monitoring of early biliubin toxicity in infants who were at risk...
Auditory Brainstem Evoked Responses in Hyperbilirubinemic Neonates.
Eun Yong Lee, Pyung Hwa Chee, Sei Joo Kim
Clin Exp Pediatr. 1987;30(8):846-851.   Published online August 31, 1987
An association between neonatal hyperbilirubinemia and hearing loss has been found in several studies. Because auditory brainstem evoked responses (ABR) may be useful tool for the monitoring of early bilirubin txicity in hyperbilirubinemic neonates, ABR in 16 fullterm neonates with serum total bilirubin values 15 mg/dl were compared with the responses in 17 control neonates. The results were as follows: 1) The statistically significant absence of...
Clinico-Hematologic Observation of Neonatal Hemolytic Disease due to Minor Blood Group Isoimmunization.
Chong Woo Bae, Yong Mook Choi, Chang Il Ahn, Hyun sok Chi
Clin Exp Pediatr. 1987;30(5):504-510.   Published online May 31, 1987
The isoimmune hemolytic diseases of the newborn due to minor blood group are characterized by the abnormal titer of minor group antibody in mother’s serum and neonatal progressive jaundice caused by isoimmune hemolytic anemia. This report present the clinico-hematologic features of six cases of hemolytic diseases of newborn due to minor blood group isoimmunization who were admitted to the Kyung Hee university Hospital and presented...
Cord Plasma Alpha-Fetoprotein Values and Neonatal Jaundice.
Mee Kyung Namgoong, Sei Hee Choi, Ae Sook Kim, Baek Keun Lim, Jong Soo Kim
Clin Exp Pediatr. 1986;29(8):836-839.   Published online August 31, 1986
Alpha-fetoprotein(aFP) levels were studied in 20 neonatally hyperbilirubinemic children and 20 controls matched for gestational age. The mean aFP value of cord blood (119+58.2산g/ml) with hyperbilirubinemic children was significantly greater than that(79.6±40.8/zg/ml) for the control infants(P<0.001). At the age of 3 and 5 days the mean serum aFP in hyperbilirubinemic children were higher compared with the control group, the difference...
The Response of Leukocytes in the Peripheral Blood Following Exchange Transfusion in the Newborn.
Young Mo Sohn, Yu Young Chang, Young Ho Kim, Kir Young Kim
Clin Exp Pediatr. 1983;26(11):1049-1054.   Published online November 30, 1983
We have studied the hemoglobin level and. leukocyte count of 23 fullterm and 1 premature jaundiced babies soon after exchange transfusion and daily thereafter until 7 days. The resixlts are: 1) One exchange transfusion was enough in 16 patients but 8 were required more than 2times of exchange transfusion. The maximum is 6 times. 2) The postnatal age was...
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