966 Hyperbilirubinemia in a Cohort of Infants in a Normal Newborn Nursery (NNN)

Abstract

Background and aims: Jaundice is one of the most frequent indications for diagnostic and therapeutic intervention in otherwise normal newborns. The aim of the study was to analyse the frequency, severity and treatment of hyperbilirubinemia in relation to national guidelines in infants cared for in NNN. Methods: All infants cared for in NNN in 2008 with a measurement of serum bilirubin were included in the study. Patient data was gathered retrospectively from patient records. Results: Bilirubin was measured in 593 jaundiced infants (16.3 % of cohort) with an average of 4,9 analyses/infant (median 4, range 1 - 25). Maximum bilirubin (TsB) was increased in moderately premature infants compared to term and postterm infants. TsB ≥ 300 µmol/L and ≥ 350 µmol/L was seen in 35.2 and 14.5 % of jaundiced infants, respectively. Six infants were diagnosed with TsB ≥ 400 µmol/L, only one had blood group immunization (AB0). TsB was significantly related to older mothers and higher parity and in infants with greater weight loss. Infants born after c-section had significantly lower TsB, and no effect of gender, Apgar score, or season was found. Phototherapy (PT) was given to 50.3 % of jaundiced infants, i.e. 7.3 % of NNN cohort. 109 infants (20.3 % of jaundiced infants) were readmitted for PT, 75 of these had been discharged with increasing TsB. Conclusions: Hyperbilirubinemia is a major problem in NNN. Early discharge and significant weight loss is a risk factor for severe hyperbilirubinemia, as well as being discharged with increasing jaundice.