Background: Neonatal jaundice is the most common cause of hospitalization in the first month of life. Factors that reportedly affect the severity of neonatal jaundice include: maternal, prenatal and neonatal factors as well as environmental factors (such as zinc). Animal study demonstrated a decrease in serum bilirubin level after zinc treatment in hyperbilirubinemic rats.Objectives: The current study aimed to investigate serum zinc level in the neonates with idiopatic jaundice.Patients and Methods: A case-control study was undertaken from 2008 to 2010 on 263 neonates in a neonatal intensive care unit and obstetrics department in Ghaem hospital, Mashhad, Iran. Of the 263 infants, 114 and 149 neonates were in the control and the case groups, respectively. Infants with a gestational age of>35 weeks or with idiopathic jaundice were included in the study. Exclusion criteria were as follows: neonates with sepsis or any congenital abnormalities or with glucose-6-phosphate dehydrogenase (G-6PD) deficiency, ABO and RH incompatibility. Serum levels of zinc and bilirubin were compared between the control (114 neonates without jaundice) and case (149 neonates with jaundice) groups using atomic absorption spectrometry. The maternal and neonatal information were recorded. Spearman correlation coefficient, chi-square and Mann-Whitney tests were employed to analyze the data by SPSS software.Results: The mean value of the zinc serum level was 1024.74±245.17 mmol/L in the control group and 841.42±211.99 mmol/L in the case group (P<0.001). There was no significant correlation between zinc level and factors such as maternal age, multi parity, mode of delivery, hospitalization and gender of infants (P>0.05). Also, no significant correlation was observed between serum levels of Na, blood urea nitrogen (BUN), creatinine (Cr), white blood cell (WBC), platelet, hematocrit (Hct) and zinc (P>0.05).Conclusions: The level of serum zinc in the neonates with hyperbilirubinemia jaundice was lower than that of the ones without jaundice. It seems that zinc has a protective effect. However, more studies are needed for better decision making.

Glomerular filtration rate is low in fetal and neonatal life. It increases after birth and reaches approximately 20 mL/min/1.73 m2 at 1 month of age in term and preterm neonates. Various methods have been used to measure glomerular filtration rate in neonates such as inulin clearance, creatinine clearance, and serum cystatin C. Serum creatinine concentrations are influenced by many factors. It is suggested to use other markers which are stable over time and are not affected by muscle mass or tubular reabsorption and secretion. Cystatin C incorporates these characteristics; however, there are some other limitations in the use of cystatin C as a marker of kidney function in neonates. Additionally, the numbers of studies focused on the use of cystatin C in neonates is limited. There is a need for further studies to determine cystatin C’s normal range levels and investigate whether cystatin C can replace other tests such as serum creatinine as marker of kidney function in newborn babies. Assessment of newer kidney function tests is also warranted in newborn infants.

Background: Congenital hypothyroidism is one of the most common preventable causes of mental retardation. The present study aimed to compare the characteristics of neonates with false-positive congenital hypothyroidism screening test results with affected neonates in Kerman. Methods: This cross-sectional study was conducted on neonates called to confirm congenital hypothyroidism from 2016 to 2017. The neonate characteristics (year and season of birth, sex, umbilical hernia, fontanelle conditions, constipation, jaundice, abnormalities, head circumference, height and weight at birth, gestational age, type of delivery, parental consanguinity, history of thyroid disease in the family, childbirth location, history of hospitalization, and place of residence) and maternal characteristics (age, number of deliveries, history of stillbirth, history of illness, and drug use during pregnancy) were extracted from their medical records. The collected data were analyzed with SPSS software (version 20) using the chi-square and independent samples t test. Results: From a total of 985 neonates who had a positive screening test, congenital hypothyroidism was confirmed in only 58 neonates(5. 9%), and the other 927 neonates(94. 1%) only had a positive screening test. The neonates’,and mothers’,characteristics were not significantly different in the two groups, except for constipation, which had a higher frequency in the neonates with a positive congenital hypothyroidism screening results than in the affected neonates (P = 0. 004). Conclusion: In this study, the characteristics of neonates who only had a positive hypothyroidism screening test result were not significantly different from those of the affected neonates. It is recommended that further studies be conducted over a longer period.

Introduction: Increased level of indirect bilirubin causes neurologic symptoms. Some of these symptoms may be subclinical starting with decreased feeding and dehydration. The aim of the present study was to evaluate the prevalence of prerenal azotemia in neonates with jaundice and determine its relationship with other variables.Materials and Methods: In a cross-sectional study, 199 neonates admitted with hyperbilirubinemia were included. They had no other complaints. Data about gestational age, age at the onset of jaundice and age of admission were recorded. At the time of admission, blood samples for measurement of BUN, Cr, and bilirubin level were collected. Neonates with prerenal azotemia were detected. Correlation between azotemia, level of bilirubin and other variables was evaluated.Results: Mean gestational age of the neonates in the present study was 38.2±1.8 weeks. 58.7% of them were male and 10.9% were premature. Mean age at the onset of jaundice and age at the time of admission were 4.2±2.9 and 6.1±3.5 days, respectively. Mean bilirubin level at the time of admission was 17.5±3.1 mg/dl. Based on BUN level at the time of admission, 10.7% of the neonates had prerenal azotemia. There was a significant correlation between age at the onset of jaundice and age of admission, bilirubin level and BUN level and prevalence of azotemia.Conclusion: Neonates with hyperbilirubinemia may have subclinical symptoms and low appetite causing dehydration. We suggest evaluating the neonates with high bilirubin level for hydration status and possibility of prerenal azotemia especially in younger neonates.

Background: Chorioamnionitis (CAM) is one of the major risk factors for neonatal early-onset sepsis (EOS). Different international guidelines have been developed for diagnosis and care of such neonates. This research aimed to evaluate our neonates and compare them with the guidelines. Methods: This prospective cohort study was conducted during five years (March 2012 to March 2017), and comprised of neonates (any gestational age) born to mothers with CAM (any criteria). The neonates’ clinical findings and interventions were collected and analyzed. Results: In total, out of 28, 988 live born neonates, CAM was found in mothers of 169 neonates (1. 7%). Among the studied neonates, 30. 8% were born ≤ 34 week of gestation, 39% had birth weight <2500 g, and 58. 6% were asymptomatic. Out of 99 asymptomatic neonates, 47 were observed near mothers and 52 admitted to the neonatal intensive care unit (NICU). The frequency of abnormal tests was 23. 07% in asymptomatic vs. 35. 7% in symptomatic neonates; three neonates developed culture positive EOS (2. 75%) and 68. 05% of the neonates received antibiotics. The length of stay was 2. 59 ± 1. 13 (median = 2. 00, IQR = 1. 00) days in asymptomatic vs. 15. 15 ± 13. 67 (median = 7. 00, IQR = 15. 25) days in symptomatic neonates (P < 0. 001). Conclusion: The use of guidelines increased the length of stay, lab tests, and antibiotics in asymptomatic and neonates with negative blood culture. In addition to the mother-neonate separation, these guidelines may increase nosocomial infection, antibiotic resistance, and costs; therefore, new guidelines are needed to be developed.

The authors report two cases of neonatal parotitis which is a rare infection in newborns and has been reported less than 120 times in world literature. Neonatal bacterial parotitis is commonly represented with fever and swelling and erythema in the preauricular area. The treatment requires appropriate use of antibiotics for 7-10 days.Our patients were a 16 day old boy who was presented with fever, poor feeding, swelling, redness, indurations and tenderness of left preauricular region and a 10 day old girl who admitted due to fever, restlessness, swelling and erythematic of left external auricular region.Both of them were treated successfully with parenteral antibiotics for 7 days which were followed by oral antibiotics.

Background: Hydronephrosis as a major health issue, has a significant contribution to the loss of kidney function and dialysis. Based on this the aim of this was to evaluate the probably etiology of hydronephrosis in neonates. Methods: We have evaluated 314 neonates with fetal hydronephrosis (by ultrasonography) as a study group. Cases were followed by voiding cystourethrogram 3 weeks after the start time. In addition, we took a Diethylenetriaminepentaacetic Acid scan at the end of 1st month of childbirth. At the end, we evaluated data based on the statistical analysis. Based on these examinations, etiology of hydronephrosis were examined and recorded. Results: In total 314 infants with hydronephrosis (55. 7% male and 44. 3% female) were included. Idiopathic cause (42%) as the most common etiology and vesicoureteric reflux as 2nd most common etiology of hydronephrosis have been evaluated (37. 4%). Conclusions: Based on this finding, different causes can induce hydronephrosis as a different etiology; therefore, we can control and reduce hydronephrosis by checking vesicoureteric reflux as the most common possible etiology.