1 - Hospital Dona Estefânia - Pediatrics Department, Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal,
2 - Hospital Dona Estefânia - Pediatric Nephrology Unit, Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal,
3 - Hospital Dona Estefânia - Pediatric Gastroenterology and Hepatology Unit, Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal,
4 - Hospital Dona Estefânia - General Pediatrics Unit, Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal
- Poster Viewing in the 55th Annual Meeting of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition, Viena, Austria 17-20 May 2023
Objectives and Study: Neonatal unconjugated hyperbilirubinemia (NUH), a common condition that can lead to neurotoxicity, has a higher incidence in the Indian subcontinent when compared to Europe. With the increase of migrating populations, namely in Portugal, it is important to acknowledge its characteristics to determine the most suited approach for each patient. Our study’s goal was to compare two groups with NUH: Indian subcontinent ancestry (ISA) and European ancestry (EA) newborns.
Methods: Observational retrospective cohort study enrolling newborns with NUB admitted to a tertiary hospital, between January/2016 and December/2021. Sociodemographic, clinical and laboratorial data of study group/SG (ISA) and control group/CG (EA) were compared. Patients with cholestasis were excluded. Statistical analysis with SPSS®, ɑ=0,05.
Results: 110 newborns were included, 69 (62.7%) males, 27 (24.5%) from the SG and 83 (75.5%) from the CG. Mean age in SG was 9.7days (DP4.7) versus 7.1 days (DP4.1) in CG (p=0,004). SG’s maximum total bilirubinemia was 22.07 mg/dL versus 19.62 mg/dL in CG (p=0.010), with 10 newborns (9.09%) having a bilirubinemia peak greater than 25mg/dL, 6 of these (60%) from SG. 104 (94.5%) newborns underwent phototherapy, with no differences in phototherapy duration. Bilirubin levels at discharge were 13.60mg/dL in SG versus 11.30 mg/dL in CG (p=0.005). Seven (6.36%) performed genetic study, with 4 revealing UGT1A1 mutations: one with reduced UGT activity and three thought to have no impact in UGTA1 activity. All of these genetic changes were in SG.
Conclusions: In newborns of ISA, mean age at admission was higher, as well as peak and discharge total bilirubin levels. The majority of patients with severe NUH were from ST/ISA. All UGTA1 mutations were detected in SG patients. More studies are needed to better understand NUH impact on ISA children’s neurodevelopment. The hypothesis of using different reference intervals, according to the geographic origin, is questioned.
Palavras Chave: Neonatal hyperbilirubinemia, UGTA1 mutations, neurodevelopment