The first 24-hour bilirubin level as a predictor of hyperbilirubinemia in healthy term newborns
Keywords:
first day bilirubin level, neonatal hyperbilirubinemia
Abstract
Background Early discharging healthy term newborns results ina difficulty to recognize hyperbilirubinemia.
Objective The aim of this study was to determine the value of the
first 24-hour total and unbound bilirubin levels in predicting hyper-
bilirubinemia in healthy term newborns.
Methods The first 24-hour and the 5 th day total and unbound
bilirubin levels were measured in 84 healthy term newborns. The
total bilirubin level was measured spectrophotometrically, whereas
unbound bilirubin level was determined by peroxidase-oxidation
method. Hyperbilirubinemia was defined as serum total bilirubin of
>12.9 mg/dL or serum unbound bilirubin of >0.5 mg/dL after 24
hours of life.
Results A correlation between the first 24-hour and the 5 th day
total bilirubin levels was found (r= 0.53) with a regression equa-
tion: Y (total bilirubin on day 5) = 4.69 + 1.15X (total bilirubin in the
first 24 hours). In unbound bilirubin (r=0.31), the regression equa-
tion was Y (unbound bilirubin on day 5) = 0.13 + 0.95X (unbound
bilirubin in the first 24-hours). The relative risk for developing hy-
perbilirubinemia in newborns whose TB 1 was >4.5 mg/dL was 12
(95% CI 2.9;48.4), whereas newborns whose UB 1 was >0.09 mg/
dL was 9.5 (95% CI 1.2;77.4).
Conclusion Total bilirubin level of >4.5 mg/dL in the first 24 hours
can predict the development of hyperbilirubinemia in term new-
borns in the first week of life. Newborns with such level of total
bilirubin need a longer stay or should visit the hospital on day 5-7
References
1. Seidman DS, Stevenson DK, Ergaz Z, Gale R. Hospi-
tal readmission due to neonatal hyperbilirubinemia.
Pediatrics 1995;96:727-9.
2. Chatz C, Hanson JW, Simpson L, Yaffe SJ. Summary of
workshop: early discharge and neonatal Hyperbiliru-
binemia. Pediatrics 1995;96:743-5.
3. Lee KS, Perlman B, Ballantyne M, Elliot I, To T. Asso-
ciation between duration of neonatal hospital stay and
readmission. J Pediatr 1995;127:758-66.
4. Gale R, Seidman DS, Stevenson DK. Hyperbilirubine-
mia and early discharge. J Perinatol 2001:21:40-3.
5. Johnson L and Bhutani VK. Guidelines for manage-
ment of the jaundiced term and near-term infant. Clin
Perinatol 1998;25:555-73.
6. Penn AA, Enzmann DR, Hah JS, Stevenson DK.
Kernicterus in a full-term infant. Pediatrics
1993;93:1003-6.
7. Sola A. Changes in clinical practice and bilirubin en-
cephalopathy in “healthy term newbornsâ€. Pediatr Res
1995;37:145A.
8. Maisels MJ, Newman TB. Kernicterus in otherwise
healthy, breast-fed term newborns. Pediatrics
1995;96:730-3.
9. American Academy of Pediatrics Practice Parameter.
Management of Hyperbilirubinemia in the healthjy
term newborn. Pediatrics 1994;94:558-65.
10. Bhutani VK, Johnson L, Sivieri EM. Predictive ability
of a predischarge hour-specific serum bilirubin for sub-
sequent significant hyperbilirubinemia in healthy term
and near-term newborns. Pediatrics 1999;103:6-14.
11. Alpay F, Sarici SU, Tosuncuk HD, Serdar MA, Inanc
N, Gokcay E. The value of first-day bilirubin measure-
ment in predicting the development of significant hy-
perbilirubinemia in healthy term newborns. Pediatrics
2000;106:e16.
12. Seidman DS, Ergaz Z, Paz I, Laor A, Revel-Vilk S,
Stevenson DK, et al. Predicting the risk of jaundice
in fullterm healthy newborns: a prospective popula-
tion-based study. J Perinatol 1999;19:564-7.
13. Nakamura H, Yonetani M, Uetani Y, Funato M, Lee Y.
Determination of serum unbound bilirubin for predic-
tion of kernicterus in low birthweight infants. Acta
Pediatr Jpn 1992;34:642-7.
14. Cadhore WJ, Oh W. Unbound bilirubin and ker-
nicterus in low birt weight infants. Pediatrics
1982;69:481-5.
15. Alisjahbana A, Chaerulfatah A, Usman A,
Sutresnawati S. Anthropometry of newborn infants
born in 14 teaching centers in Indonesia. Pediatr
Indones 1994;34:62-123.
16. Bhutani VK, Johnson LH, Sivieri EM. Universal new-
born bilirubin screening. Pediatr Res 1997;41:191A.
17. Adams JA, Hey DJ, Hall RT. Incidence of hyperbiliru-
binemia in breast– vs formula–fed infants. Clin Pediatr
1985;24:69-73.
18. Johnson CA, Lieberman L, Hassenein E. The relation-
ship of breast feeding to third day bilirubin levels. J
Fam Pract 1985;20:147-52.
19. Osborn LM, Bolus R. Breast feeding and jaundice in
the first week of life. J Fam Pract 1986;20:475-80.
20. Surjono A. Breast milk, weight loss and hyperbiliru-
binemia in fullterm newborn infants in the first week
of life. Berkala I Kedokt 1993;1:42-8.
21. Bertini G, Dani C, Tronchin M, Rubaltelli FF. Is
breastfeeding really favoring early neonatal jaundice ?
Pediatrics 2001;107:e41.
22. Gomella TL, Cunningham MD, Eyal FG. Neonatol-
ogy: management, procedures, on-call problems, dis-
eases and drugs. 3 rd ed. Connecticut: Appleton &
Lange; 1994. p. 311-23.
23. Amato M, Howald H, Muralt G. Fat content of hu-
man milk and breast milk jaundice. Acta Pediatr Scand
1985;74:805-6.
24. Poland RL, Schulz GE, Garg G. High lipase activity
association with breast milk jaundice. Pediatr Res
1980;14:1328-31.
25. Surjono A. Total and unbound bilirubin concentration in
Indonesian newborn infants. ICMR Annals 1986;6:53-9.
tal readmission due to neonatal hyperbilirubinemia.
Pediatrics 1995;96:727-9.
2. Chatz C, Hanson JW, Simpson L, Yaffe SJ. Summary of
workshop: early discharge and neonatal Hyperbiliru-
binemia. Pediatrics 1995;96:743-5.
3. Lee KS, Perlman B, Ballantyne M, Elliot I, To T. Asso-
ciation between duration of neonatal hospital stay and
readmission. J Pediatr 1995;127:758-66.
4. Gale R, Seidman DS, Stevenson DK. Hyperbilirubine-
mia and early discharge. J Perinatol 2001:21:40-3.
5. Johnson L and Bhutani VK. Guidelines for manage-
ment of the jaundiced term and near-term infant. Clin
Perinatol 1998;25:555-73.
6. Penn AA, Enzmann DR, Hah JS, Stevenson DK.
Kernicterus in a full-term infant. Pediatrics
1993;93:1003-6.
7. Sola A. Changes in clinical practice and bilirubin en-
cephalopathy in “healthy term newbornsâ€. Pediatr Res
1995;37:145A.
8. Maisels MJ, Newman TB. Kernicterus in otherwise
healthy, breast-fed term newborns. Pediatrics
1995;96:730-3.
9. American Academy of Pediatrics Practice Parameter.
Management of Hyperbilirubinemia in the healthjy
term newborn. Pediatrics 1994;94:558-65.
10. Bhutani VK, Johnson L, Sivieri EM. Predictive ability
of a predischarge hour-specific serum bilirubin for sub-
sequent significant hyperbilirubinemia in healthy term
and near-term newborns. Pediatrics 1999;103:6-14.
11. Alpay F, Sarici SU, Tosuncuk HD, Serdar MA, Inanc
N, Gokcay E. The value of first-day bilirubin measure-
ment in predicting the development of significant hy-
perbilirubinemia in healthy term newborns. Pediatrics
2000;106:e16.
12. Seidman DS, Ergaz Z, Paz I, Laor A, Revel-Vilk S,
Stevenson DK, et al. Predicting the risk of jaundice
in fullterm healthy newborns: a prospective popula-
tion-based study. J Perinatol 1999;19:564-7.
13. Nakamura H, Yonetani M, Uetani Y, Funato M, Lee Y.
Determination of serum unbound bilirubin for predic-
tion of kernicterus in low birthweight infants. Acta
Pediatr Jpn 1992;34:642-7.
14. Cadhore WJ, Oh W. Unbound bilirubin and ker-
nicterus in low birt weight infants. Pediatrics
1982;69:481-5.
15. Alisjahbana A, Chaerulfatah A, Usman A,
Sutresnawati S. Anthropometry of newborn infants
born in 14 teaching centers in Indonesia. Pediatr
Indones 1994;34:62-123.
16. Bhutani VK, Johnson LH, Sivieri EM. Universal new-
born bilirubin screening. Pediatr Res 1997;41:191A.
17. Adams JA, Hey DJ, Hall RT. Incidence of hyperbiliru-
binemia in breast– vs formula–fed infants. Clin Pediatr
1985;24:69-73.
18. Johnson CA, Lieberman L, Hassenein E. The relation-
ship of breast feeding to third day bilirubin levels. J
Fam Pract 1985;20:147-52.
19. Osborn LM, Bolus R. Breast feeding and jaundice in
the first week of life. J Fam Pract 1986;20:475-80.
20. Surjono A. Breast milk, weight loss and hyperbiliru-
binemia in fullterm newborn infants in the first week
of life. Berkala I Kedokt 1993;1:42-8.
21. Bertini G, Dani C, Tronchin M, Rubaltelli FF. Is
breastfeeding really favoring early neonatal jaundice ?
Pediatrics 2001;107:e41.
22. Gomella TL, Cunningham MD, Eyal FG. Neonatol-
ogy: management, procedures, on-call problems, dis-
eases and drugs. 3 rd ed. Connecticut: Appleton &
Lange; 1994. p. 311-23.
23. Amato M, Howald H, Muralt G. Fat content of hu-
man milk and breast milk jaundice. Acta Pediatr Scand
1985;74:805-6.
24. Poland RL, Schulz GE, Garg G. High lipase activity
association with breast milk jaundice. Pediatr Res
1980;14:1328-31.
25. Surjono A. Total and unbound bilirubin concentration in
Indonesian newborn infants. ICMR Annals 1986;6:53-9.
Published
2016-10-10
How to Cite
1.
Triasih R, Haksari E, Surjono A. The first 24-hour bilirubin level as a predictor of hyperbilirubinemia in healthy term newborns. PI [Internet]. 10Oct.2016 [cited 25Apr.2024];43(3):85-0. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/667
Section
Articles
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Received 2016-09-23
Accepted 2016-09-23
Published 2016-10-10
Accepted 2016-09-23
Published 2016-10-10
