43 HULTIVARIATE ANALYSIS OF FACTORS RELATED TO NON-HEROLYTIC HYPERBI-LIRUBINEMIA OF FULL-TERM NEWBORN INFANTS

Abstract

The relation between hyperbi1irubinemia in the first 4 days of life and a number of perinatal variables was studied in 456 healthy full-term (GA ≥ 37 weeks) singleton infants delivered consecutively between Jan and May 1987. All infants were free from malformations and/or any other disease reguiring treatment, they were ABO and Rh compatible with their mothers and were not G6PD deficient. The serum bilirubin level was < 137 μmol/t (<8 ag/dl) in 46% of the study subjects, between 137 and 255 μmol/L (8-14.9 mg/dl) in 39% and > 256 μmol/L (≥ 15 mg/dl) in 15%. An association (P<0.05) with hyperbilirubinemia was found for male sex, low gestational age (GA), prolonged labour or rupture of membranes, instrumental vaginal delivery, excessive weight loss (in turn related to poor feeding), delayed meconium passage, high levels of alpha-fetoprotein (AFP) in cord blood and history of jaundice in a previous sibling born at term. It was ndt possible to compare breast vs formula-feeding since nearly all babies (94%) were exclusively breast-fed. After adjustment for confounders with a log-linear model, only high levels of AFP, excessive weight loss, jaundice in a previous sibling and low GA still showed an independent association with hyperbilirubinemia. These results suggest that in our population inherited and constitutional factors and feeding play the most important role in the genesis of non-hemolytic jaundice in healthy full-terra infants.