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Extreme Hyperbilirubinemia in Newborn Infants

Department of Pediatrics, Division of Neonatology, Baskent University Faculty of Medicine, Adana, Turkey

Hande Gulcan, MD

Department of Pediatrics, Division of Neonatology, Baskent University Faculty of Medicine, Adana, Turkey

Hasan Kilicdag, MD

Department of Pediatrics, Division of Neonatology, Baskent University Faculty of Medicine, Adana, Turkey

Aylin Tarcan, MD

Department of Pediatrics, Division of Neonatology, Baskent University Faculty of Medicine, Ankara, Turkey

Berkan Gurakan, MD

Department of Pediatrics, Division of Neonatology, Baskent University Faculty of Medicine, Ankara, Turkey

This study was undertaken to determine the frequency and investigate the etiology of extreme hyperbilirubinemia (total serum bilirubin [TSB] 25 mg/dL [428 µmol/L]) in newborns admitted to a neonatal intensive care unit in southern Turkey. The charts of 93 term and near-term infants admitted with TSB levels of 25 mg/dL (428 µmol/L) or greater in the first 30 days after birth were retrospectively reviewed. During the 4.5-year study period, 774 infants were admitted to our unit with neonatal jaundice. Ninety-three (12%) of these infants had TSB levels of 25 mg/dL (428 µmol/L) or greater. The mean TSB level in the 93 cases was 30.1 ± 5.7 mg/dL (514.7 ± 97.5 µmol/L), and the peak levels ranged from 25.0 to 57.4 mg/dL (428-981.5 µmol/L). Thirty-three (35.5%) of the 93 babies had TSB levels of 30 mg/dL (513 µmol/L) or greater. Eighty-nine of 93 infants were being exclusively breast-fed. Nineteen babies were isoimmunized, 7 were bacteremic, 2 of the 39 babies tested for glucose-6-phosphate dehydrogenase had this enzyme deficiency, and 1 of the 71 infants tested for thyroid function had hypothyroidism. No cause for extreme hyperbilirubinemia was found in 61 (65.6%) cases.

Clinical Pediatrics, Vol. 45, No. 3, 257-261 (2006)
DOI: 10.1177/000992280604500308


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