Predictive risk factors for moderate to severe hyperbilirubinemia

Article English OPEN
Gláucia Macedo de Lima ; Maria Amélia Sayeg Campos Porto ; Arnaldo Prata Barbosa ; Antonio José Ledo Alves da Cunha (2007)
  • Publisher: Instituto Israelita de Ensino e Pesquisa Albert Einstein
  • Journal: Einstein (São Paulo) (issn: 1679-4508)
  • Subject: Neonatal jaundice | Hyperbilirubinemia | neonatal | Phototherapy | Risk factors | kernicterus | Medicine | R

Objective: to describe predictive factors for severity of neonataljaundice in newborn infants treated at the University Neonatal Clinic,highlighting maternal, obstetric and neonatal factors. Methods: Acohort retrospective study by means of review of medical charts todefine risk factors associated with moderate and severe jaundice.The cohort consisted of newborns diagnosed with indirect neonatalhyperbilirubinemia and submitted to phototherapy. Risk was classifiedas maternal, prenatal, obstetric and neonatal factors; risk estimationwas based on the odds ratio (95% confidence interval); a bi-variantmultivariate regression logistic analysis was applied to variables forp < 0.1. Results: Of 818 babies born during the studied period, 94(11%) had jaundice prior to hospital discharge. Phototherapy was usedon 69 (73%) patients. Predictive factors for severity were multiparity;prolonged rupture of membranes, dystocia, cephalohematoma, a lowApgar score, prematurity and small-for-date babies. Following birth,breastfeeding, sepsis, Rh incompatibility, and jaundice presentingbefore the third day of life were associated with an increased risk ofhyperbilirubinemia and the need for therapy. Conclusion: Other thanthose characteristics that are singly associated with phototherapy,we concluded that multiparity, presumed neonatal asphyxia, low birthweight and infection are the main predictive factors leading to moderateand severe jaundice in newborn infants in our neonatal unit.
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