Post phototherapy bilirubin rebound: incidence and risk factors

Soni, Richa; Kaushik, Shayam; Kaushik, Rajni; Bhardwaj, Praveen; Mohabey, Surabhi

doi:10.18203/2320-6012.ijrms20173993

Cited by 2 publications

(14 citation statements)

References 5 publications

(12 reference statements)

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“…Diamond LK et al [10] , proposed a hypothesis for greater susceptibility to infection in male neonates due to factors responsible for defective immunoglobulin synthesis, which is located on "X" chromosome. These results were comparable with Arakhita Swain et al, [11] and Richa Soni et al, [12] as these studies also show male predominance. Arakhita Swain et al, [11] studied 126 neonates out of them 70 were male and 56 were female with sex ratio 1.25: 1; they found that 9% of female and 12.9% of male neonates developed SBR.…”

Section: Resultssupporting

confidence: 90%

“…In our study it was found that SBR was observed mainly in presence of risk factors. Similar observation were made by Al-Saedi et al, [16], Arakhita Swain et al, [11] and Richa soni et al, [12].…”

Section: Resultssupporting

confidence: 89%

“…This difference was however not found to be statistically significant (P=0.278). Richa Soni et al, [12] in a similar study found that 20% of SBR was due to prematurity. Similarly SBR was more in preterm neonates in many other studies like Dr Subhash K Valinjkar et al, [9] (42.4%); Bansal et al, [5] (22.5%); Kaplan M et al, [14] (21.9%).…”

Section: Resultsmentioning

confidence: 91%

“…These results were comparable with Arakhita Swain et al, [11] who studied 126 neonates out of them 70 were male and 56 were female with sex ratio 1.25: 1; they found that 9% of female and 12.9% of male neonates developed SBR. Richa Soni et al, [12] found that out of 509 neonates 295 (58%) were male and 214 (42%) were female.…”

Section: Resultsmentioning

confidence: 98%

“…Similarly Nikoo Niknafs et al, [6] found that 13 neonates (11.3%) out of 115 neonates developed SBR. Richa Soni et al, [12] found that out of 509, 63 neonates (12%) developed SBR.…”

Section: Resultsmentioning

confidence: 98%

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Study of Post Phototherapy Serum Bilirubin Rebound Levels in Near Term and Term Neonates

Singh¹,

Devpura²,

Gothwal³

et al. 2020

SJAMS

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Original Research ArticleNeonatal hyperbilirubinemia is common in first week of life. Nearly 60% term & 80% preterm neonates develop jaundice in first week of life. American Academy of Pediatrics recommends that new born discharged within 48 hours should have a follow-up visit after 48 -72 hours for any significant neonatal jaundice. These babies may develop jaundice which may be over looked or delay in recognition unless closely monitored. So it is necessary to measure serum total bilirubin in all jaundiced infants and ensure follow-up evaluation within 2 days of all infants discharged prior to 48 hours. Concern regarding early discharge is bilirubin induced neurological dysfunction (BIND) in healthy term infants even without hemolysis. No upper limit of serum bilirubin levels are defined for development of BIND in icteric new born but serum bilirubin level >20mg/dl is likely to be toxic and leads to significant brain damage. The pathogenesis of BIND is complex and related to the interplay between levels of unconjugated bilirubin, gestational maturity of infants and integrity of blood brain barrier. The concept of prediction of neonatal jaundice is an attractive option for clinical assessment of neonatal jaundice. Our study states that out of 150 neonates, 86 neonates (57.3%) no rebound hyperbilirubinemia seen, 47 (31.3%) developed insignificant rebound hyperbilirubinemia (i.e. serum bilirubin level increases after discontinuation of phototherapy but not crossed cut-off value of starting phototherapy), 10 (6.7%) developed significant bilirubin rebound (SBR) at 12 hours of discontinuation of phototherapy and 7 (4.7 %) developed SBR at 24 hours of discontinuation of phototherapy. So patient having higher serum bilirubin at the time of discontinuation of phototherapy along with risk factors developed more SBR. There are only few options for treatment of neonatal jaundice which are: Phototherapy, Exchange transfusion, Drugs like phenobarbitone, intravenous immunoglobulin.

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Section: Resultssupporting

confidence: 90%

Section: Resultssupporting

confidence: 89%

Section: Resultsmentioning

confidence: 91%

Section: Resultsmentioning

confidence: 98%

“…Similarly Nikoo Niknafs et al, [6] found that 13 neonates (11.3%) out of 115 neonates developed SBR. Richa Soni et al, [12] found that out of 509, 63 neonates (12%) developed SBR.…”

Section: Resultsmentioning

confidence: 98%

See 3 more Smart Citations

Study of Post Phototherapy Serum Bilirubin Rebound Levels in Near Term and Term Neonates

Singh¹,

Devpura²,

Gothwal³

et al. 2020

SJAMS

View full text Add to dashboard Cite

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Risk Factors for Serum Bilirubin Rebound After Stopping Phototherapy in Neonatal Hyperbilirubinemia

Yadav

Maini

Gaur

et al. 2021

Journal of Neonatology

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Objective: To identify the factors affecting rebound increase in bilirubin levels after stopping phototherapy in neonatal hyperbilirubinemia. Setting: Tertiary-level neonatal unit. Patients: This was a hospital-based cross-sectional observational study. The study was conducted in neonatal division of rural tertiary care hospital. All neonates who were admitted for hyperbilirubinemia treatment and fulfilled the inclusion criteria were included in the study. Inclusion Criteria: All neonates 1.5 kg and above and treated in newborn intensive care unit for hyperbilirubinemia. Exclusion Criteria: (a) Critically ill patients requiring respiratory support any time after delivery, (b) neonates presenting with life-threatening surgical conditions, (c) patient with congenital malformation, (d) conjugated bilirubin elevation, (e) patients with birth asphyxia. Statistical Analysis: All the data were entered into a Microsoft Excel sheet. Appropriate tests of significance were applied. The various variables were sorted and presented as a number or percentage. The categorical variables used in the analysis were evaluated using the chi-square test (Yates’s correction and Fischer exact test were employed where applicable). The continuous data were analyzed by “t” test. The P value of less than 0.05 was taken to be level of statistical significance. Results: One hundred and fifty patients of neonatal hyperbilirubinemia were included in this study. In this study, 81 newborns (54.0%) were male and 78 (52%) of them were born by normal vaginal delivery. One hundred and nine babies (72.6%) were term babies. Fifty babies (33.3%) were low birth weight. Out of 150 neonates, 18(12%) had ABO incompatibility, 13(8.7%) Rh incompatibility, 23(15.7%) neonatal sepsis, and 4 (2.6%) had polycythemia. Out of 150 patients, 15(10%) babies had rebound hyperbilirubinemia at 24 h of life requiring phototherapy prematurity (particularly <34 weeks) ( P value: .03), low birth weight (particularly <2.0 kg) ( P value:.009), onset of jaundice requiring phototherapy before 72 h of life ( P value .04), blood group (both Rh and ABO) incompatibility ( P values: .001 and .002), neonatal sepsis ( P value: .004) were significantly associated with rebound hyperbilirubinemia. Glucose 6 phosphate dehydrogenase (G6PD) deficiency, polycythemia, maturity, mode of feeding, and gender did not show any statistical significant relationship with rebound hyperbilirubinemia. Conclusions: Rebound level of bilirubin need not be checked in all babies. Babies with risk factors like born preterm, low birth weight, having sepsis, requirement of phototherapy before 72 h of life, Rh and ABO group incompatibility, only need to be checked for serum bilirubin rebound. We recommend more studies with larger sample size to evaluate all these factors including polycythemia and G6PD deficiency.

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Post phototherapy bilirubin rebound: incidence and risk factors

Cited by 2 publications

References 5 publications

Study of Post Phototherapy Serum Bilirubin Rebound Levels in Near Term and Term Neonates

Study of Post Phototherapy Serum Bilirubin Rebound Levels in Near Term and Term Neonates

Risk Factors for Serum Bilirubin Rebound After Stopping Phototherapy in Neonatal Hyperbilirubinemia

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