Review of patients hospitalized due to indirect hyperbilirubinemia: A retrospective, observational study
Murat Cansever1, Ahmet Ozdemir2
1Erciyes University Faculty of Medicine, Department of Pediatric Allergy and Immunology, Kayseri, Turkey
2Kayseri Training and Research Hospital, Department of Pediatric Neonatology, Kayseri, Turkey
Aim: The aim of our study to identify characteristics of patients admitted to our hospital due to indirect hyperbilirubinemia and to determine risk factors for indirect hyperbilirubinemia.
Material and Methods: The study included 130 patients (gestational age≥36 weeks) who admitted to newborn clinic with the diagnosis of indirect hyperbilirubinemia. In all patients, risk factors, peripheral venous serum samples, complete blood count and biochemical parameters before and after phototherapy were assessed. The phototherapy and exchange transfusion decisions were made according to total serum bilirubin (TSB) levels proposed by Turkish Neonatology Association.
Result: In patients included, mean gestational age was 38.54±0.95 weeks (range: 36-41) while mean birth weight was 3241.53±414.60 g (range: 2020-4400). Of the patients, 71 (54.6%) were boys. Time of presentation was 3.56±1.2 days while total bilirubin level was 21.31±3.83 mg/dL. No underlying cause was detected in 71 patients while there was dehydration in 30 (23.0%), ABO incompatibility in 41 (31.5%) and Rh incompatibility in 20 patients (15.3%). Mean phototherapy duration was 69.78±20.36 hours (range: 48-120). Seven patients received intravenous immunoglobulin (IVIG) therapy. Of these, there was Rh incompatibility in 4 patients and ABO incompatibility in 3 patients. Overall, 6 patients underwent exchange transfusion. In 3 patients, exchange transfusion was required despite IVIG therapy. The hemoglobin, MCV and total bilirubin levels were 15.89±2.92 g/dL, 105.51±6.59 fL and 21.31±3.83 mg/dL before therapy whereas 14.07±2.90 g/dL, 101.41±8.15 fL and 11.33±2.18 mg/dl after therapy, respectively.
Conclusion: Based on our results, the most common cause of hyperbilirubinemia is idiopathic jaundice ((most probably physiological jaundice or breast milk jaundice) in newborns; followed by ABO incompatibility.