Abstract
Background: Hyperbilirubinemia is a common and in most cases, benign problem in neonates. Data in term and near-term infants with respect to the pattern of neonatal hyperbilirubinemia from South India are lacking, hence this study. Aim: The aim was to compare the incidence of significant hyperbilirubinemia between near terms and term neonates. Materials and Methods: A prospective case–control study done in a Tertiary Care Hospital, in South India over a period of 18 months (October 2012–April 2014) involving two hundred and sixty-four infants (cases 132 near-term babies, and 132 terms controls). Setting: Tertiary Care Hospital, in South India over a period of 18 months (October 2012–April 2014). Participants: Two hundred and sixty-four infants, cases 132 near-term babies, and 132 terms controls. Exclusion Criteria: Babies with hemolytic jaundice, polycythemia, hypothyroidism, culture-proven sepsis, major congenital anomalies. Cord and 24 h total serum bilirubin was done on cases and controls and all babies were followed up till 72 h or till discharge for significant hyperbilirubinemia. Results: Mean cord blood bilirubin values were significantly different between the near terms and terms 1.9 ± 1.41 and 1.46 ± 0.50 mg/dl (P = 0.0001). Mean 24 h serum bilirubin was higher in near terms, but the difference was not statistically significant (6.89 ± 0.41 and 6.83 ± 0.34, P = 0.764). Incidence of significant hyperbilirubinemia was statistically higher in the near terms as compared to terms (23/109 vs 7/125, P = 0.002). Conclusion: Although cord blood bilirubin was higher in near-term infants, the 24 h bilirubin did not show any significant difference between the two groups. Clinically, however, significant hyperbilirubinemia requiring phototherapy was significantly higher in near-term infants. There is clearly a requirement for at-risk assessment for severe hyperbilirubinemia before discharge and close follow-up thereafter for near-term infants.
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