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All Journal BALI MEDICAL JOURNAL (BMJ) Medicina Sari Pediatri Paediatrica Indonesiana Medicinus : Jurnal Kedokteran ISM (Intisari Sains Medis) : Jurnal Kedokteran Bioscientia Medicina : Journal of Biomedicine and Translational Research Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Jurnal Ilmiah Permas: Jurnal Ilmiah STIKES Kendal Jurnal Prima Medika Sains Bioscientia Medicina : Journal of Biomedicine and Translational Research Pediatric Sciences Journal Indonesian Journal of Multidisciplinary Science Jurnal Kedokteran Meditek Cermin Dunia Kedokteran
I Wayan Bikin Suryawan
Bagian/SMF Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Udayana/RSUP Sanglah, Denpasar
Humanities Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Education Engineering Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Library & Information Science Mathematics Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary

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Correlation Between APGAR Scores and the Incidence of Hyperbilirubinemia in Neonates at Wangaya Regional General Hospital, Denpasar Putri Widyastiti, Ni Nyoman; I Wayan Bikin Suryawan; Anak Agung Made Sucipta
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 5 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i5.995

Abstract

Background: Hyperbilirubinemia is defined as total serum bilirubin level at ≥ 5 mg/dl. In Indonesia, the prevalence of jaundice is 13,7-85%. One of the risk factors for hyperbilirubinemia in neonates is babies born with a history of asphyxia. The diagnosis of asphyxia can be enforced by the APGAR scoring system. This study aims to determine the relationship between APGAR values and the incidence of hyperbilirubinemia in neonates treated at Wangaya Regional General Hospital. Methods: This research is an analytic observational study using a cross-sectional approach, which was carried out in April-May 2022. The sample was taken by consecutive sampling. Bivariate analysis was performed using the chi-square test. Confounding variables will be controlled by design and by analysis. Influential risk factors were analyzed multivariate with logistic regression. Data were analyzed with SPSS software. Results: From 84 samples, 67, 9% had hyperbilirubinemia. The 1-minute APGAR score (P = 0,017, OR = 8,373, 95% CI; 1,468 – 47,738) and the 5-minute APGAR score (P = 0,034, OR =8,680, 95% CI; 1,172 – 64, 293) had significant correlation with the incidence of hyperbilirubinemia in neonates treated at Wangaya Regional General Hospital. Conclusion: Low APGAR scores have a significant correlation with the incidence of hyperbilirubinemia in neonates treated at Wangaya Regional General Hospital. The factor that most influences the incidence of hyperbilirubinemia is the 1-minute APGAR score. Neonates born with a low 1-minute APGAR score are 8,3 times at risk of experiencing hyperbilirubinemia.
Packed red cell transfusions in preterm neonates: a retrospective study Sulistio, Ivena Clairine; Delicia Rudy; Putu Siska Suryaningsih; I Wayan Bikin Suryawan
Pediatric Sciences Journal Vol. 6 No. 2 (2025): In Press Online : December 2025
Publisher : Medical Faculty of Brawijaya University, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/pedscij.v6i2.142

Abstract

Introduction: Preterm neonates are highly vulnerable to anemia. Packed red cell (PRC) transfusions are often necessary but must be carefully considered due to associated risks. This study aims to assess the characteristics of preterm infants who received PRC transfusions to guide safer and effective transfusion practices. Methods: This study was conducted using a retrospective descriptive approach. It included preterm neonates who received PRC transfusions, as documented in the medical records from July 2022 to March 2025. Patient characteristics, hemoglobin level, transfusion profile, and comorbidities in preterm neonates receiving PRC transfusions were evaluated. Results: The sample consisted of 52 neonates, 37 boys, and 15 girls. The gestational age of infants was mainly between 28 and <32 weeks (64,5%). Most neonates were very low birth weight, which is 53,8%. The mode of delivery was relatively similar between spontaneously and cesarean section. The average length of hospital stay was 35.27 ± 16.62 days. The initial hemoglobin level of preterm infants receiving PRC transfusions averaged 10.88 ± 1.33 g/dL. The first transfusion was typically administered at 18.10 ± 9.69 days of life. Notably, most infants (59.6%) required three or fewer transfusions. The most common comorbidity among preterm infants receiving PRC transfusions was respiratory distress syndrome (RDS) at 78.8%, followed by neonatal jaundice (53.8%) and asphyxia (40.4%). Most RDS cases (69.2%) were caused by hyaline membrane disease (HMD). Conclusion: Preterm neonates receiving PRC transfusions had a high-risk profile, underscoring the importance of individualized transfusion thresholds and close post-transfusion monitoring to improve clinical outcomes.
Diagnostic Value of Platelet-to-Lymphocyte Ratio Versus Neutrophil-to-Lymphocyte Ratio in Early-Onset Neonatal Sepsis: A Retrospective Analysis in a Limited-Resource Setting Delicia Rudy; Nova Damayanti; Putu Siska Suryaningsih; I Wayan Bikin Suryawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1507

Abstract

Background: Early-onset neonatal sepsis remains a critical cause of mortality in developing nations. Blood culture, the gold standard, suffers from delay and low sensitivity. While hematologic indices such as neutrophil-to-lymphocyte ratio (NLR) are used in adults, their utility in the first 72 hours of life is confounded by physiological instability. This study evaluates the diagnostic accuracy of the platelet-to-lymphocyte ratio (PLR) compared to NLR, mean platelet volume (MPV), and red cell distribution width (RDW) in early-onset neonatal sepsis. Methods: A retrospective observational study was conducted on 55 neonates (25 septic, 30 symptomatic non-septic controls) at a tertiary center in Indonesia. Sepsis was defined by clinical criteria and C-reactive protein positivity, independent of complete blood count parameters, to avoid incorporation bias. Diagnostic performance was assessed using Mann-Whitney U tests, receiver operating characteristic curve analysis, and multivariable logistic regression to control for confounders, including asphyxia. Results: The median PLR was significantly lower in the sepsis group compared to controls (32.6 [IQR 3.4–100.4] versus 71.1 [IQR 45.3–82.9]; p = 0.016). Conversely, NLR (p = 0.80), MPV (p = 0.163), and RDW (p = 0.422) showed no significant discrimination. PLR yielded an area under the curve of 0.724. At a cut-off of equal to or less than 40.5, determined by the Youden Index, PLR demonstrated a sensitivity of 68.0%, specificity of 73.3%, positive likelihood ratio of 2.55, and negative likelihood ratio of 0.44. Multivariable regression confirmed PLR as an independent predictor (Adjusted Odds Ratio 0.96; 95% CI 0.93–0.99; p = 0.038) after adjusting for birth asphyxia. Conclusion: PLR demonstrates superior discriminative ability over NLR for early-onset sepsis in this cohort. The distinct inverse PLR phenomenon reflects sepsis-induced thrombocytopenia and bone marrow suppression. While not a standalone diagnostic tool, PLR serves as a valuable, zero-cost adjunctive marker for risk stratification in resource-limited settings.
Diagnostic Value of Platelet-to-Lymphocyte Ratio Versus Neutrophil-to-Lymphocyte Ratio in Early-Onset Neonatal Sepsis: A Retrospective Analysis in a Limited-Resource Setting Delicia Rudy; Nova Damayanti; Putu Siska Suryaningsih; I Wayan Bikin Suryawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1507

Abstract

Background: Early-onset neonatal sepsis remains a critical cause of mortality in developing nations. Blood culture, the gold standard, suffers from delay and low sensitivity. While hematologic indices such as neutrophil-to-lymphocyte ratio (NLR) are used in adults, their utility in the first 72 hours of life is confounded by physiological instability. This study evaluates the diagnostic accuracy of the platelet-to-lymphocyte ratio (PLR) compared to NLR, mean platelet volume (MPV), and red cell distribution width (RDW) in early-onset neonatal sepsis. Methods: A retrospective observational study was conducted on 55 neonates (25 septic, 30 symptomatic non-septic controls) at a tertiary center in Indonesia. Sepsis was defined by clinical criteria and C-reactive protein positivity, independent of complete blood count parameters, to avoid incorporation bias. Diagnostic performance was assessed using Mann-Whitney U tests, receiver operating characteristic curve analysis, and multivariable logistic regression to control for confounders, including asphyxia. Results: The median PLR was significantly lower in the sepsis group compared to controls (32.6 [IQR 3.4–100.4] versus 71.1 [IQR 45.3–82.9]; p = 0.016). Conversely, NLR (p = 0.80), MPV (p = 0.163), and RDW (p = 0.422) showed no significant discrimination. PLR yielded an area under the curve of 0.724. At a cut-off of equal to or less than 40.5, determined by the Youden Index, PLR demonstrated a sensitivity of 68.0%, specificity of 73.3%, positive likelihood ratio of 2.55, and negative likelihood ratio of 0.44. Multivariable regression confirmed PLR as an independent predictor (Adjusted Odds Ratio 0.96; 95% CI 0.93–0.99; p = 0.038) after adjusting for birth asphyxia. Conclusion: PLR demonstrates superior discriminative ability over NLR for early-onset sepsis in this cohort. The distinct inverse PLR phenomenon reflects sepsis-induced thrombocytopenia and bone marrow suppression. While not a standalone diagnostic tool, PLR serves as a valuable, zero-cost adjunctive marker for risk stratification in resource-limited settings.
Co-Authors A.A Made Sucipta A.A Made Widiasa A.A. Made Sucipta A.A. Made Widiasa Adi Wirawan Alberto Afrian Alice Indradjaja, Alice Aman B Pulungan Anak Agung Made Sucipta Anak Agung Made Sucipta Anak Agung Made Sucipta Anak Agung Made Sucipta Anak Agung Made Sucipta Anak Agung Made Sucipta, Anak Agung Made Anak Agung Made Widiasa Anak Agung Made Widiasa Anak Agung Made Widiasa Andreas Eric Andrew Permana Suliarta Arimbawa * Arumndari, Runi Ayu Setyorini Mestika Mayangsari Bambang Tridjaja AAP, Bambang Tridjaja Bella Kurnia Bella Kurnia Cahaiantari, Ni Putu Elis Callista Beatrice Christina, Jessica Chyntia Conchita Christal Yasadipura Cynthia Cynthia Cynthia Cynthia Cynthia Cynthia Cynthia Jodjana Delicia Rudy Dewi, Made Ratna Doddy Kurnia Indrawan Edbert Wielim Elien Yuwono Erica Lidya Yanti Gosal, Jessica H Salim I Dewa Gede Ugrasena I Gde Doddy Kurnia Indrawan, I Gde Doddy Kurnia I Gusti Amanda Jaya I Gusti Lanang Sidiartha I Kadek Serisana Wasita I Kadek Suarca I Kadek Suarca I Made Arimbawa IB Mahendra Ida Bagus Ramajaya Sutawan, Ida Bagus Ramajaya Ida Bagus Wiadnyana IKG Suandi IM Widiaskara Imanuel Yulius Malino Jeven Reggie Santoso Jose RL Batubara Kadek Suarca Kadek Suarca Kadek Suarca, Kadek Kanthi Soraca Widiatmika Ketut Ariawati Komang Tria Anggareni Kurnia, Bella Liman, Claudia Natasha Lukman, Leni Made Cynthia Mahardika Putri Made Dwi Purnami Made Ratna Dewi Made Ratna Dewi Made Ratna Dewi Made Widiasa Mayland Margaretha Sunata Melisa Anggraeni Mustika, Putu Pradnyanita Nova Damayanti Paramerta, Ni Putu Gladys Arys Predani, Ni Luh Putu Diaswari PT Pramitha Putri Prashanti, Nyoman Ananda Putri Widyastiti, Ni Nyoman Putri, Asterisa Retno Putu Andrie Setiawan Putu Pramitha Rahayu Putu Siska Suryaningsih Putu Wahyu Dyatmika Tanaya Regina Suriadi Retno Putri, Asterisa Ruby Kurniawan Soetjiningsih Soetjiningsih Soetjiningsih Soetjiningsih Sriwaningsi, Lina Stanley Haryono Suarca, I Kadek Sukarno, Theodora Sulistio, Ivena Clairine Sunartini Sunartini Suriadi, Regina Suryaningsih, Putu Siska Susan Natalia Budihardjo sutanti sutanti Valerie Michaela Wilhelmina Widiasa - Wielim, Edbert William Grandinata Soeseno