All issues > Volume 48(10); 2005

Original Article

Korean J Pediatr. 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 JH Hwang¹, Ji Hyun JH Lee², Yu Jin YJ Kim², Su Hyun SH Koo², Jang Hun JH Lee², Chang Won CW Cho³, Yun Sil YS Chang², Won Soon WS 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

Correspondence Won Soon WS 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.

Keywords :Jaundice , Hyperbilirubinemia , Kernicterus , Newborn