الفهرس 
Neonatal hyperbilirubinemiaOnly 14 pages are availabe for public view
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Abstract
Jaundice is one of the most common and annoying problem affect the new born, it affects about 60% of full term infants and 80% of preterm infants in the first 3 days of life.
Hyperbilirubinemia is the most common reason for rehospitalization during the first month after birth.
However, phototherapy is considered one of the most effective non-invasive treatment of neonatal indirect hyperbilirubinemia,many hazards and side effects were reported from its use .
So, a lot of trials were done to avoid phototherapy in treatment of neonatal indirect hyperbilirubinemia or to decrease its duration
Oral zinc has been reported to decrease the serum total bilirubin (STB), presumably by decreasing the enterohepatic circulation. This study evaluates serum zinc level alterations before and after phototherapy in hospitalized hyperbilirubinemic newborns undergoing phototherapy.
To fulfill this aim,92 fullterm newborns with physiological jaundice who admitted to the neonatal intensive care unit (NICU) and outpatient clinic of Menoufia University .
Neonates were subdivided in 2 groups according to serum bilirubin on admission :
group (Ia):Neonates with serum bilirubin less than 18 mg/dl .
group (Ib): Neonates with serum bilirubin more than 18 mg/dl .
Blood samples were obtained from hyperbilirubinemic newborns before and after exposure to phototherapy ,we measure serum zinc level before and after phototherapy,also we measure total serum bilirubin level before and after phototherapy
Inclusion criteria:
All newborn infants with gestational age ≥37 weeks with physiological jaundice and birth weight ≥ 2500g who required phototherapy in the first week of life according to the hour-specific total bilirubin values as follows:
24 hours of age: >12 mg/dL (205 micromol/L)
48 hours of age: >15 mg/dL (257 micromol/L)
72 hours of age: >18 mg/dL (308 micromol/L)
Exclusion criteria:
• Congenital infections.
• Birth asphyxia.
• Sepsis.
• Instrumental delivery (vacuum), Cephalehematoma.
• Preterm neonate.
All cases included in the study were subjected to:
• Ӏ Through maternal history taking including; maternal diseases (diabetes –autoimmune), RH blood group and premature rupture of membrane (PROM).
• ӀӀ Meticulous systemic examination of the newborn including assessment of gestational age by Ballard score (Ballard et al., 1991), anthropometric measurements, vital signs and systemic examination with special emphasis on neurological examination including activity, positioning, tone, reflexes and cry.
• Our results showed that:
1: There was no statistical significance correlation between serum zinc before phototherapy and the studied parameters (P≥0.05).
2: There was no significant correlation between serum zinc level and the gender of the neonates either before or after phototherapy (Pvalue> 0.05).
3: There was no significant correlation between serum zinc level and mode of delivery either before or after phototherapy (P value >0.05).
4: Serum zinc level significantly increased after phototherapy(P≤0.05).
5: There was no significant difference between patients with serum bilirubin less and more than 18 mg/dl as regarding the gender and mode of delivery (P≥0.05).
6: There was no statistical significant difference between patient less and more than 18 mg/dl regarding hemoglobin percentage (p≥0.05).
7: There was no significant differance between patients with serum bilirubin less and more than 18 mg /dl as regard serum zinc level before phototherapy (P≥0.05). While there was high significant difference between the studied patients as regard serum zinc level after phototherapy(P≤0.05).
8:Phototherapy was associated with a significant increase in the serum zinc level in neonates with severe hyperbilirubinemia(TSB ˃18 mg/dL) but not in those with mild-moderate hyperbilirubinemia (TSB < 18 mg/dL).