The clinical analysis of 1444 cases of neonatal indirect hyperbilirubinemia

Tong Xiaomei, Zhang Xuefeng

Department of Pediatrics, The Third Affiliated Hospital, Peking University,

China

Objective: To investigate the causes and clinical characteristics of indirect hyperbilirubinemia in newborns.

Methods: According to causes, 1444 cases of neonatal indirect hyperbilirubinemia from 1990 to 1999 admitted to our hospital were divided into six groups, the incidence and clinical characteristics of different groups were analyzed.

Results: Hyperbilirubinemia accounts for 34.7% among all newborns admitted to hospital. The ratio of male and female is 1.4:1. 95.8% of cases have clinical jaundice prior to 7 days. The most high value of serum bilirubin is 513umol/L.The cause seriation in newborns with indirect hyperbilirubinemia were perinatal factor (28%), unknown reason (24%), hemolytic disease (20%), breast jaundice (14%) and infection (10%). Breast feeding jaundice accounts for 85% in breast jaundice. The age (mean ±SD) of onset of hyperbilirubinemia induced by hemolytic disease of newborns was significantly earlier than that due to other causes (P<0.05), while the proportion of severe jaundice have no signiffiences among the groups of hemolytic disease, breast jaundice and infection (P>0.05). The time that jaundice was discovered and bilirubin come to peak value in breast jaundice was later than other groups (P<0.05). There was no significant differences in peak value of bilirubin among six groups (P>0.05).

Conclusions The incidence of neonatal indirect hyperbilirubinemia was decreased compared with the era of 1980s. Perinatal factor was still the first important cause of hyperbilirubinemia. Control and reduce the pathological perinatal factors could brought to the reduction of incidence of neonatal hyperbilirubinemia. Part of cases of unknown cause and breast feeding jaundice might be physiological jaundice.

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