Korean J Pediatr.  2005 Oct;48(10):1102-1106.

Etiology, Management, and Prognosis of Severe Hyperbilirubinemia (Serum Bilirubin Level=25 mg/dL) in Newborn

• Hwang JH
• Lee JH
• Kim YJ
• Koo SH
• Lee JH
• Choi CW
• Chang YS
• Park WS

Abstract

PURPOSE
The present study examined the etiology, management, and the difference of prognosis according to methodology of treatment in severe hyperbilirubinemia with total serum bilirubin levels of more than 25 mg/dL. METHODS: Medical records of severe hyperbilirubiemia in newborns (serum level=25 mg/dL) admitted to the NICU of Samsung Medical Center between October 1994 and June 2004 were reviewed retrospectively. Infants were grouped according to methodology of treatment: Group I (phototherapy only, n=42), Group II (exchange transfusion, n=6). And In addition, we evaluated the etiology and the difference of prognosis. RESULTS: A total of 48 documented cases of severe hyperbilirubinemia were identified. Birth weight was significantly lower in Group 2 (2, 852+/-1, 085 g) compared to Group 1 (3, 137+/-437 g) (P< 0.05). There were no significant differences in gestational age, sex, mode of delivery, inborn, age at presentation, and age at first examination and admission between the two study groups. Maximal bilirubin level was significantly higher in Group 2 (45+/-16 mg/dL) compared to Group 1 (29+/-6 mg/dL) (P< 0.05). But there were no significant differences in neurologic outcome. CONCLUSION: Our study suggests that the present guidelines for managing hyperbilirubinemia in newborns should be effective but follow-up with the first postnatal week would be necessary for each detection and treatment in the newborn infants with high risk of severe hyperbilirubinemia.

Keyword

Jaundice; Hyperbilirubinemia; Kernicterus; Newborn

MeSH Terms

Bilirubin*
Birth Weight
Follow-Up Studies
Gestational Age
Humans
Hyperbilirubinemia*
Infant
Infant, Newborn*
Jaundice
Kernicterus
Medical Records
Prognosis*
Retrospective Studies
Bilirubin