FARHANA RAHAT1, MAHFUZA SHIRIN2, MD. M. MONIR HOSSAIN 3
Abstract
Introduction: Neonatal hyperbilirubinemia is a cause of major concern for the parents
as well as the pediatricians due to chance of neurotoxicity. Early prediction of
development of significant hyperbilirubinemia can reduce anxiety and duration of
hospital stay.
Objective: To find out the risk of development of significant hyperbilirubinemia among
preterm newborn within first seven days of life.
Methodology: This prospective study was carried out in Dhaka Shishu Hospital
during the period of January to June, 2007. One hundred & eleven preterm newborns
of 30-37 weeks gestational age were enrolled in first day of their life and their serum
total and indirect bilirubin were estimated on the 1st, 2nd, 5th & 7th day. Neonates with
evidence of hemolysis, direct hyperbilirubinemia, sepsis & major congenital
malformation were excluded. Their 1st and 2nd day serum total bilirubin values were
analyzed statistically at different cut off points from which significant hyperbilirubinemia
can develop on 5th & 7th day of life.
Results: The study included 111 premature neonates of 30-37 weeks gestation who
were enrolled on first day of their life. Their mean gestational age was 33.7(±2) weeks
and mean birth weight was 1754(±341) gm. Of them, 38 (34%) neonates developed
significant hyperbilirubinemia within first seven days of life. Among the study population,
40 (36%) neonates had serum total bilirubin value of <2 mg/dL on first day of life.
None of them developed significant hyperbilirubinemia (100% negative predictive
value). Again 65 (58.5%) neonates had serum total bilirubin value of <5 mg/dL on
second day of life. Among them only 7.6% developed significant hyperbilirubinemia
(92.3% negative predictive value).
Conclusion: The first and second day serum total bilirubin values can predict
subsequent hyperbilirubinemia within seven days of life. First day serum total bilirubin
value of 2 mg/dL can be taken as a safe limit from which chance of significant
hyperbilirubinemia is less.
Key words: Hyperbilirubinemia, preterm, Sepsis