Predicting Nonhemolytic Neonatal Hyperbilirubinemia

Abstract

BACKGROUND: Before hospital discharge, newborn infants should be assessed for the risk of excessive hyperbilirubinemia. We determined maternal and obstetric risk factors for hyperbilirubinemia in infants born at term (gestational age $37 weeks) to form an individualized risk assessment tool for clinical use.

Haemolytic and nonhaemolytic neonatal jaundice have different risk factor profiles

“…Nevertheless, one of the authors (SJ) reported that one Swedish neonatology unit only recorded ICD codes for jaundice if the cases required phototherapy or exchange transfusion, as instructed in the national guidelines (9). Furthermore, the rates of jaundice reported for our 1987-2002 cohort were very similar to those recorded by Swedish cohort mentioned above, which covered 1999-2012 (13). Our rates of haemolytic jaundice were 0.59% and 0.49%, and the rates of nonhaemolytic jaundice in term infants were 2.2% and 1.9%, respectively.…”

“…First, the importance of pregnancy risk factors such as older maternal age and higher maternal BMI for nonhaemolytic jaundice provide a plausible link between multiple disparate causes of nonhaemolytic jaundice. To our knowledge, the association with maternal obesity has only been previously reported in another publication based on a Swedish cohort (13). Mothers with higher BMI are more likely to have infants with complications such as birth trauma, bacterial sepsis and preterm birth, conditions that are linked with jaundice (16,17).…”

“…Norman et al. published a similarly large study that included term infants born in Sweden from 1999 to 2012. Although our cohort included births from 1987 to 2002, our findings were similar regarding the rates of jaundice and the associations with maternal age, parity and BMI.…”

“…In contrast, pregnancy factors were the dominant risk factors for nonhaemolytic jaundice, including preterm birth, being the first born child and maternal overweight or obesity. Norman et al (13) published a similarly large study that included term infants born in Sweden from 1999 to 2012. Although our cohort included births from 1987 to 2002, our findings were similar regarding the rates of jaundice and the associations with maternal age, parity and BMI.…”

Fertility Treatment Is Associated with Stay in the Neonatal Intensive Care Unit and Respiratory Support in Late Preterm Infants

“…Maternal age and cesarean delivery are risk factors associated with hyperbilirubinemia (32, 33), as well as fertility treatment conceptions which may in part explain our finding.…”