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

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.