Bodyweight loss in predicting neonatal hyperbilirubinemia 72 hours after birth in term newborn infants

Abstract

BackgroundSevere dehydration is generally believed to be a cause of significant hyperbilirubinemia in newborn babies. This study aimed to analyze the weight loss of healthy term newborn infants at 24, 48 and 72 hours after birth to predict significant hyperbilirubinemia at 72 hours.MethodsFrom January 2007 to December 2008, we conducted this retrospective chart review by measuring total bilirubin (transcutaneous and serum) in 343 healthy, term newborns with a birth body weight of more than 2500 g. We then analyzed the association between body weight loss (BWL) and significant hyperbilirubinemia (total bilirubin more than 15 mg/dL) 72 hours after birth. Receiver operating characteristic curves were used to evaluate the appropriate cutoff BWL percentages on the first three days after birth for the prediction of neonatal hyperbilirubinemia 72 hours after birth.ResultsA total of 115 (33.5%) neonates presented with significant hyperbilirubinemia 72 hours after birth, and the percentages of BWL on the first three days were all higher than those in the non-significant hyperbilirubinemia group (all p < 0.05). Breastfeeding was not statistically correlated with significant hyperbilirubinemia (p=0.86). To predict significant hyperbilirubinemia 72 hours after birth, receiver operating characteristic curve analysis showed that the optimum cutoff BWL percentages were 4.48% on the first day of life (sensitivity: 43%, specificity: 70%, positive likelihood ratio [LR+]: 1.43, and negative likelihood ratio [LR-]: 0.82), 7.60% on day 2 (sensitivity: 47%, specificity: 74%, LR+: 1.81, LR-: 0.72), and 8.15% on day 3 (sensitivity: 57%, specificity: 70%, LR+: 1.92, LR-: 0.61) (all p < 0.05).ConclusionsBWL on the first three days after birth may be a predisposing factor for neonatal hyperbilirubinemia, and may also serve as a helpful clinical factor to prevent significant hyperbilirubinemia 72 hours after birth. The optimal BWL cutoff percentages on the first three days after birth presented in this study may predict hyperbilirubinemia and indicate the need for supplementary feeding.

Transcutaneous bilirubin nomogram for Taiwanese newborns – A single center study

“…32 Physiological body weight loss is common in early life and a high body weight loss may be a predisposing factor for neonatal hyperbilirubinemia. 9 However, we observed no difference in TCB level between newborns with body weight loss (BWL) less than 10% and those with a BWL of greater than or equal to 10% (significant BWL). In this study, only 71 newborns had significant BWL; this number is relatively low compared with that of a previous report.…”

“…It is difficult to estimate bilirubin levels visually, particularly in infants with different skin colors. 9,10 Compared with TSB, transcutaneous bilirubin (TCB) measurement offers a rapid check for jaundice, with noninvasive stress, shorter time, lower cost, and an accurate estimation of bilirubin level. 11e15 The use of TCB has become popular among health professionals in nurseries.…”

Clinical profile of hypernatremia in exclusively breast-fed neonates

“…Similarly, Uras et al and Korgali et al, have found that 14% and 2.4% of their hypernatremic babies were asymptomatic at admission, respectively. 17,18 Five babies with severe hypernatremia had neurological and/or renal complications. Similarly, Ahmed et al have found that babies with AKI presented at a later age, had higher weight loss and higher serum sodium.…”

Breastfeeding jaundice: how big is the problem?

“…Subjective indicators of adequate breastfeeding are 4 to 6 thoroughly wet diapers in 24 hours, 3 to 4 times passage of stool by 4th day and change in stools from meconium to mustard yellow mushy stools by 4 th day. 3 A body weight loss of more than 7-10% by day 3 is taken as an objective measure of inadequate breastfeeding. 4 Breastfeeding jaundice, a preventable form of non-physiological jaundice, develops in 13% of exclusively breastfed infants during the 1 st week of life.…”