The early indicator of significant hyperbilirubinemia in healthy full-term infants at 72 hrs of age: A prospective cohort study

Sunil Arys,Chetan Panwar,Jyoti Prajapati

doi:10.17511/ijpr.2021.i03.02

Abstract

Introduction Hyperbilirubinaemia is a very common and frequently benign condition in newborns,but is a leading cause of hospitalisation in the first week of life. Many healthy full-term newbornsdevelop significant hyperbilirubinemia, often leading to serious complications as bilirubinencephalopathy and death. The present study was aimed to determine early predators and riskfactors in full-term healthy newborns developing significant hyperbilirubinemia. Methods - This wasa prospective observational cohort study conducted at the department of pediatrics at a tertiary careteaching hospital over 1 year enrolling 200 full-term healthy newborns and following them from birthto 72 hrs of life to determine early predictors of hyperbilirubinemia. The data were analysed usingthe Statistical Package of Social Science Software (SPSS) program. Bilirubin levels measured at 72hrs were compared to identify significant hyperbilirubinemia using cut off at or above highintermediate risk zone in Bhutani nomogram. Results- Neonates with birth weight <2.5 kg, bornthrough instrumental delivery, delayed feeding, dehydration, 24 Hr serum bilirubin >6mg/dl and 48Hr serum bilirubin >11 mg/dl were significantly associated with significant hyperbilirubinemia(p<0.05) Conclusion- These risk factors can be used as risk indicator to predict the development ofsignificant hyperbilirubinemia in such newborns and better pre-discharge counselling and followupcan be ensured in such newborns especially in resource-limited settings.

Highlights

Hyperbilirubinaemia is a very common and frequently benign condition in newborns, but is a leading cause of hospitalisation in the first week of life
Neonates with birth weight 6mg/dl and 48 Hr serum bilirubin >11 mg/dl were significantly associated with significant hyperbilirubinemia( p
200 newborns were enrolled in the study and analysed for the association of various demographic, clinical, and laboratory markers for early prediction of significant hyperbilirubinemia in the study cohort. 55.5% of the newborn were male and 45.5% were female. 185(92%) newborns included were between 37 to 40 weeks, and 7.5% were above 40 wk of gestation. 173(86%) were appropriate for gestational age, 22 newborns (11%) were Short for gestational age, and 5 newborns were Large for gestational age. [Table1] Out of 200 newborns 19 newborns (33.5%) developed hyperbilirubinemia above high intermediate zone at 48 hrs while

Summary

Introduction

Hyperbilirubinaemia is a very common and frequently benign condition in newborns, but is a leading cause of hospitalisation in the first week of life. Many healthy full-term newborns develop significant hyperbilirubinemia, often leading to serious complications as bilirubin encephalopathy and death. The present study was aimed to determine early predators and risk factors in full-term healthy newborns developing significant hyperbilirubinemia. Neonatal hyperbilirubinemia accounted for 13 deaths per 1000 live births globally and ranked seventh leading cause among all causes of neonatal mortality in the first week of life.[1]. In some newborns, this can cause severe complications progressing to acute bilirubin encephalopathy and kernicterus with a high risk of neonatal mortality and long-term neurodevelopmental impairments. Even moderate hyperbilirubinemia is found to be associated with an increased risk of minor neurologic dysfunction in the first year of life which is often considered safe.[3]

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