Objective:

Hyperbilirubinemia is a common and, in most cases, benign problem in newborns. Nonetheless, untreated, severe indirect hyperbilirubinemia is potentially neurotoxic. The aim of this study is to evaluate the etiological factors and clinical characteristics of newborns with indirect hyperbilirubinemia.

Material and Methods:

In this study, 319 newborns with indirect hyperbilirubinemia were investigated prospectively at Vak›f Gureba Education and Research Hospital. Blood groups, infection criteria, hemotocrits, direct Coombs tests, reticulocyte values, glucose-6-phosphatase (G6PD) levels, thyroid-stimulating hormone and thyroxin levels were determined. In newborns with indirect hyperbilirubinemia, phototherapy was initiated according to the guidelines proposed by the American Academy of Pediatrics.

Results:

The gender and gestational age of the infants were 202 (%63.3) male, 117 (%36.7) female; 266 (%83.4) term, 53 (%16.6) preterm. When etiological factors were considered, 109 cases (%34.1) were idiopatic, 67 cases (%21) were ABO incompatibility, 15 cases (%4.7) were Rh incompatibility, 7 case (%2.3) were ABO and Rh incompatibility, 43 cases (%13.5) were prematurity, 25 cases (% 7.8) were polycythemia, 30 cases (%9.4) were infection, 9 cases (%2.8) were cephalohematoma, 4 cases (%1.2) were G6PD deficiency, 5 cases (%1.5) were infant of a diabetic mother, 2 cases (%0.7) were trisomy 21, 3 cases (%1) were hypothyroidism. Bilirubin levels higher than 25 mg/dl were detected in 7 (% 2.3) cases. The highest bilirubin level was 28 mg/dl, and this case had the urinary infection. In only one of the cases exchance transfusion was applied there was a fast rise in the bilirubin levels in the first 24 hours and as there was no respons to phototherapy.

Conclusion:

Hyperbilirubinemia frequently encountered problem in the newborn is not only the result of blood group incompatibility, but may also be due to sepsis, urinary tract infection, hypothyroidism, polycythemia and spesific red cell enzyme defects. Therefore a newborn presenting with jaundice should be investigated for diseases other than the temporary hyperbilirubinemia of the newborn and the family should be counsulted accordi.

Keywords: indirect hyperbilirubinemia, newborn