Etiology, Management, and Prognosis of Severe Hyperbilirubinemia (Serum Bilirubin Level=25 mg/dL) in Newborn

Hwang, Jong Hee; Lee, Ji Hyun; Kim, Yu Jin; Koo, Su Hyun; Lee, Jang Hun; Cho, Chang Won; Chang, Yun Sil; Park, Won Soon

Original Article

Korean Journal of Pediatrics 2005;48(10):1102-1106.
Published online October 15, 2005.

Etiology, Management, and Prognosis of Severe Hyperbilirubinemia (Serum Bilirubin Level=25 mg/dL) in Newborn

Jong Hee Hwang¹, Ji Hyun Lee², Yu Jin Kim², Su Hyun Koo², Jang Hun Lee², Chang Won Cho³, Yun Sil Chang², Won Soon Park²

¹Department of Pediatrics, Ilsan Paik Hospital, College of Medicine, Inje University, Korea
²Department of Pediatrics, Seoul National University Bundang Hospital, Korea
³Department of Pediatrics, College of Medicine, Sungkyunkwan University, Seoul, Korea

중증 고빌리루빈혈증(혈청 빌리루빈 >25 mg/dL)의 발병 원인과 치료 및 예후

황종희^¹^, 이지현^²^, 김유진^²^, 구수현^²^, 이장훈^²^, 최창원^³^, 장윤실^²^, 박원순^²

^¹인제대학교 의과대학 일산백병원 소아과
^²분당서울대학교병원 소아과
^³성균관대학교 의과대학 소아과학교실

Correspondence:
Won Soon Park, Email: wspark@smc.samsung.co.kr

Abstract

Purpose
: The present study examined the etiology, management, and the difference of prognosis according to methodology of treatment in severe hyperbilirubinemia with total serum bilirubin levels of more than 25 mg/dL.
Methods
: Medical records of severe hyperbilirubiemia in newborns(serum level=25 mg/dL) admitted to the NICU of Samsung Medical Center between October 1994 and June 2004 were reviewed retrospectively. Infants were grouped according to methodology of treatment : Group I(phototherapy only, n=42), Group II(exchange transfusion, n=6). And In addition, we evaluated the etiology and the difference of prognosis.
Results
: A total of 48 documented cases of severe hyperbilirubinemia were identified. Birth weight was significantly lower in Group 2(2,852?,085 g) compared to Group 1(3,137?37 g)(P<0.05). There were no significant differences in gestational age, sex, mode of delivery, inborn, age at presentation, and age at first examination and admission between the two study groups. Maximal bilirubin level was significantly higher in Group 2(45?6 mg/dL) compared to Group 1(29? mg/dL) (P<0.05). But there were no significant differences in neurologic outcome.
Conclusion
: Our study suggests that the present guidelines for managing hyperbilirubinemia in newborns should be effective but follow-up with the first postnatal week would be necessary for each detection and treatment in the newborn infants with high risk of severe hyperbilirubinemia.

Key Words: Jaundice , Hyperbilirubinemia , Kernicterus , Newborn