The Frequency and Etiology of Exchange Transfusion among Hospitalized Neonates with Hyperbilirubinemia in Qom, Iran from 2001 to 2011

Jaundice is a common neonatal disease caused by the limited ability of a newborn to metabolize indirect bilirubin, culminating in hyperbilirubinemia. This in turn may predispose the newborn to kernicterus and other complication if not managed promptly. One of the most common management is exchange transfusion. This study aims to determine the frequency and etiology of exchange transfusion performed for neonatal hyperbilirubinemia in Qom, Iran. Material & Methods: In this cross sectional study, the researcher reviewed medical records of 144 newborns who underwent exchange transfusion at Children Hospital in Qom, Iran, from 2001 to 2011. Birth weight, sex, the weight before admission, serum bilirubin on admission and during exchange transfusion, gestational age, blood group and Rh of mother and newborn, complete blood count, total and direct serum bilirubin, direct Coomb's test, reticulocyte count, TSH, and G6PD activity were determined. All statistical analyses were performed using SPSS (Version 11.5). Results: Results showed exchange transfusion was performed due to ABO incompatibility (36.5%), Rh incompatibility (14.5%), G6PD deficiency (5%), G6PD deficiency and ABO incompatibility (4%), and other reasons (40%). The mean bilirubin level at admission was 27.3 mg/dl and mean bilirubin level during exchange transfusion was 26 mg/dl. The mean level of serum bilirubin was 27.3 mg/dl on admission and 26 mg/dl during exchange transfusion. Symptoms of kernicterus appeared in 10 newborns, out of whom 5 (50%) were due to ABO incompatibility, 1 due to Rh incompatibility (10%), 1 due to Rh incompatibility (10%), and 3 (30%) for other reasons. Conclusion: Early detection of ABO and Rh incompatibility and G6PD deficiency in the affected newborns may be important for reducing the risk of severe hyperbilirubinemia, kernicterus, and the need for exchange transfusion. ( Mohammad Reza Shokrollahi, Hosein Heydari, Leila Nasehi, Zahra Movahedi. The Frequency and Etiology of Exchange Transfusion among Hospitalized Neonates with Hyperbilirubinemia in Qom, Iran from 2001 to 2011. Life Sci J 2013;10(12s):208-211). (ISSN:1097-8135). http://www.lifesciencesite.com . 36