Impact of Rotavirus Infection on Neonatal Hyperbilirubinemia

Mee Hong; Jung Hyun Lee

doi:10.14734/PN.2019.30.2.93

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Hong and Lee: Impact of Rotavirus Infection on Neonatal Hyperbilirubinemia

Original Article

Perinatology 2019;30(2):93-98.

Published online: 4 June 2019

DOI: https://doi.org/10.14734/PN.2019.30.2.93

Impact of Rotavirus Infection on Neonatal Hyperbilirubinemia

Mee Hong, MD, Jung Hyun Lee, MD

Department of Pediatrics, St.Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Correspondence to Jung Hyun Lee, MD Department of Pediatrics, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 93 Jungbu-daero, Paldal-gu, Suwon 16247, Korea Tel: +82-31-881-8901 Fax: +82-31-248-5520 E-mail: ljhped@catholic.ac.kr

Received 13 March 2019 Revised 22 April 2019 Accepted 5 May 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

Rotavirus (RV) infection is a common health issue in neonatal wards. Clinical outcomes include diarrhea, fever, and poor appetite. We aimed to assess the impact of RV infection on aggravation of neonatal hyperbilirubinemia and on the bilirubin response to phototherapy.

Methods

We analyzed the clinical data of 101 newborns with jaundice admitted to a neonatal ward from 2009 to 2017. Patients were divided into RV-positive and RV-negative groups, according to the RV antigen in stool samples. Statistical analyses were used to assess the RV impact on neonatal jaundice.

Results

Fifty newborns (49.5%) had RV infection. No significant differences were found between the two groups concerning mean gestational age, birthweight, age at admission, postnatal weight loss, blood urea nitrogen, base excess, and bilirubin values at admission and duration of phototherapy. The frequency of stool pass and the hospitalization period were significantly higher in the RV-positive group (P=0.002 and P=0.009, respectively). The lower the gestational age, the greater the severe jaundice (odds ratio, 0.713; P=0.028).

Conclusion

The incidence of RV infection was surprisingly high in newborns with jaundice, having a significant impact on hospitalization time, but not on hyperbilirubinemia severity and phototherapy duration. Rotavirus is highly contagious therefore, screening tests for RV infection should be included as part of the evaluation of jaundiced infants admitted to neonatal ward and prevent transmission.

Keywords: Neonate, Jaundice, Rotavirus, Phototherapy

References

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Table 1.

Demographic Characteristics and Laboratory Levels in Neo-natal Jaundice with and without Rotavirus Antigen

	RV-positive (n=50)	RV-negative (n=51)	P-value
Gestational age (weeks)	38.3±1.4	38.2±1.6	0.640
Birthweight (g)	3,171±451	3,072±398	0.263
Male (%)	66.0	52.9	0.181
Exclusive breastfeeding (%)	6.0	17.6	0.071
Age at admission (days)	6.2±1.9	6.9±3.7	0.241
Body weight at admission (g)	3,091±457	3,022±455	0.454
Use of postdelivery facility (%)	38.0	13.7	0.005
Defecation frequency	5.2±2.5	3.8±1.8	0.002
Body weight change (%)	–2.4±4.1	–1.6±5.7	0.446
Feeding amount (mL/kg/day)	168±49	187±34	0.031
Blood pH	7.39±0.82	7.38±0.52	0.678
Base excess (mmol/L)	–4.0±3.6	–3.7±3.5	0.660
BUN (mg/dL)	6.4±3.7	6.3±2.9	0.872
Sodium (mEq/L)	138.2±3.8	138.1±3.1	0.857
TcB (mg/dL)	16.9±2.5	18.1±2.8	0.028
TSB (mg/dL)	18.0±3.7	18.9±4.0	0.276
AST (IU/L)	34.1±11.5	33.6±12.4	0.850
ALT (IU/L)	16.0±9.8	12.2±4.2	0.012
Albumin (g/dL)	3.5±0.27	3.5±0.27	0.632
Duration of phototherapy (hours)	23.1±14.6	22.4±14.5	0.786
Hospital stay (days)	5.4±2.3	4.4±1.4	0.009

Values are presented as mean±standard deviation or number.

Abbreviations: RV, rotavirus; BUN, blood urea nitrogen; TcB, transcutaneous bilirubin; TSB, total serum bilirubin; AST, aspartate aminotransferase; ALT, alanine aminotransferase.

Table 2.

Demographic Characteristics and Laboratory Levels in Neo-natal Jaundice with Symptomatic Rota Viral Infection and without Rotavirus Antigen

	RV-positive symptomatic (n=26)	RV-negative (n=51)	P-value
Body weight change (%)	–2.5±3.5	–1.6±5.7	0.500
Feeding amount (mL/kg/day)	168±52	187±35	0.065
Blood pH	7.39±0.8	7.38±0.52	0.479
Base excess (mmol/L)	–3.9±4.2	–3.7±3.5	0.887
BUN (mg/dL)	5.9±2.9	6.3±2.9	0.652
Sodium (mEq/L)	137±3.7	138.1±3.1	0.400
TcB (mg/dL)	16.6±2.2	18.1±2.8	0.021
TSB (mg/dL)	17.3±2.6	18.9±4.0	0.142
AST (IU/L)	37.4±11.3	33.6±12.4	0.193
ALT (IU/L)	17.8±11.6	12.2±4.2	0.026
Albumin (g/dL)	3.5±0.24	3.5±0.27	0.309
Duration of phototherapy (hours)	25±15.6	22.4±14.5	0.467
Hospital stay (days)	5.6±2.5	4.4±1.4	0.037

Values are presented as mean±standard deviation.

Abbreviations: RV, rotavirus; BUN, blood urea nitrogen; TcB, transcutaneous bilirubin; TSB, total serum bilirubin; AST, aspartate aminotransferase; ALT, alanine aminotransferase.

Table 3.

Multivariate Analysis of the Risk Factors for Neonatal Jaundice Using Serum Bilirubin

	Odds ratio (95% confidence interval)	P-value
Gestational age	0.713 (0.527–0.964)	0.028
Weight change	0.987 (0.901–1.082)	0.784
Age at admission	1.123 (0.956–1.319)	0.157
Stool frequency	1.109 (0.908–1.354)	0.312
Feeding amount	1.002 (0.992–1.012)	0.737
Albumin	3.646 (0.641–20.722)	0.145
Rotavirus infection	0.956 (0.399–2.292)	0.920

Table 4.

Multivariate Analysis of the Risk Factors for Neonatal Jaundice Using Serum Bilirubin in Rotaviral infection

	Odds ratio (95% confidence interval)	P-value
Gestational age	0.785 (0.480–1.285)	0.336
Weight change	1.127 (0.951–1.336)	0.166
Age at admission	0.979 (0.692–1.385)	0.904
Stool frequency	0.934 (0.724–1.206)	0.602
Feeding amount	1.001 (0.989–1.014)	0.825
Albumin	4.565 (0.406–51.303)	0.219

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