Frequency of Hyperbilirubinemia at 72 Hours of Life in Term Newborns with a High-Intermediate Risk Serum Bilirubin Level At 48 Hours of Life

Abstract

Neonatal jaundice is common in newborns affecting over half (50-60%) of all babies in the first week of life. Severe jaundice can result into significant morbidity in the form of kernicterus. Early screening along with, quick treatment of neonatal jaundice helps to reduce the risk of developing severe hyperbilirubinemia, hence Kernicterus. There is strong evidence that screening newborns with hour-specific serum bilirubin level measurements can help in identifying risk of developing hyperbilirubinemia in newborns. There is insufficient data from developing countries regarding hyperbilirubinemia and newborns with and without underlying risk factors for hyperbilirubinemia. This cross sectional study will help the physician to anticipate and manage newborns with high-intermediate zone total serum bilirubin (TSB) and will also help to established specific management guideline for these newborns to prevent bilirubin induced neurological damage (BIND). All term newborns of either gender (fulfilling inclusion criteria) with TSB level at high-intermediate risk zone at 48 hours of life, born at Aga Khan University Hospital were included in this study. Their demographics were recorded in structured proforma. Results were collected and analyzed by SPSS software, version 20.0. A total of 173 newborns were enrolled. There was a female predilection 56.6% (n=98). One-third of the newborns having TSB in high-intermediate risk zone at 48 hours of life progressed to level of significant hyperbilirubinemia requiring treatment (31.2%; n=54). Those who required phototherapy had the mean rate of rise of 5.00 mg/dL/day (0.20 mg/dL/ hr). For future implementations we recommended that early recognition, monitoring and early treatment of neonatal hyperbilirubinemia may help in reducing morbidity. Neonates with high-intermediate risk serum bilirubin level should be followed at 24 hours intervel for assessment and possible treatment.