Factors Affecting Bilirubin Levels during First 48 Hours of Life in Healthy Infants

Abstract

Objective. To investigate the relationship of delivery type, maternal anesthesia, feeding modalities, and first feeding and meconium passage times with early bilirubin levels of healthy infants. Methods. Cord, 24 hours' and 48 hours' total bilirubin levels were measured in 388 study infants. Results. Infants born with cesarean section were fed later and more often had mixed feeding. First meconium passage was delayed with general anesthesia. Cord, 24 and 48 hours' bilirubin levels were not correlated with first feeding time, meconium passage time, mode of delivery, existence and type of anesthesia, and feeding modalities. Being in high intermediate risk zone at 72 hours of Bhutani's nomogram was only related to first feeding time and high cord bilirubin level. Late preterm infants were more frequently born with cesarean section and offered supplementary formula. Therefore, first meconium passage times and bilirubin levels were similar in the late preterm and term infants. Conclusions. Type of delivery or anesthesia, late prematurity, feeding modalities, and first meconium passage time were not related to early bilirubin levels in healthy neonates, but delayed first feeding and high cord bilirubin levels were related to be in higher risk zone for later hyperbilirubinemia.

Clinical characteristics influence cultivable-bacteria composition in the meconium of Indonesian neonates

“…Hypothyroid is also one risk factor known to influence hyperbilirubinemia, but from the neonatal screening, none of our samples were found to have abnormal thyroid results [ 31 ]. Other possible risk factors for the development of hyperbilirubinemia were not included in the study due to the limited availability of data; initiation of feeding were only ranged as within 24 h, no data on the different hours [ 32 ] or the lack of definitive association found from previous studies [ 32 , 33 , 34 ].…”

Identification of neonatal haemolysis: an approach to predischarge management of neonatal hyperbilirubinemia

“…Delivery by C‐section either could be a protective or could place an infant at risk for suboptimal breast milk intake (starvation) jaundice of the newborn. In a previous study, infants delivered by C‐section (86% were exclusively breastfed) had a later initiation of first feeding , possibly confounded by the enterohepatic recirculation of bilirubin and indirectly contributing to their development of hyperbilirubinemia. When combined with a universal predischarge TB test, identification of infants with TB >75th percentile on the Bhutani nomogram will guide targeted follow‐up, anticipation of the need for phototherapy and exploration of the pathological basis for the increased bilirubin load.…”

UGT1A1Genetic Variations and a Haplotype Associated with Neonatal Hyperbilirubinemia in Indonesian Population

“…Jaundice is a common physiological phenomenon in neonates as it occurs almost in 60% of healthy term newborns [ 1 , 2 ]. Neonatal hyperbilirubinemia (NH) is a condition when jaundice with the serum total bilirubin (STB) levels is above the 95th percentile for age in hours [ 3 ]. In the most severe cases, NH leads to chronic bilirubin encephalopathy (kernicterus) which is characterized by severe athetoid cerebral palsy, sensory hearing loss, dental-enamel dysplasia, paralysis upward gaze, and mortality.…”