Predisposing Factors for Progression of Hyperbilirubinemia from Low Risk to High Risk in Healthy Full Term Neonates
Introduction: The great burden of neonatal hyperbilirubinemia is exemplified by the fact that globally about 60% of the term and the 80% of preterm babies develop jaundice. Concerns regarding an apparent increase in kernicterus had put forward non invasive new approaches in its prevention and diagnosis in worldwide mainly focusing on body weight loss and feeding pattern in newborns. Objectives: To correlate post natal weight loss with serum bilirubin level during first 72 hours in term newborns and to determine the association of other factors. Method: This prospective observational study included 350 full term neonates who were assessed for clinical jaundice, body weight loss and feeding pattern for the first 72 hours of life. Daily TcB and TSB was done on Day 3. Results: Among the 350 term neonates they were categorized into risk zone based on TSB level in which 217 (62%) were in low, 127 (36%) were in intermediate and 7 (2%) were in high risk zone. The study revealed a significant (p <0.001) difference in mean body weight loss (%) values between these risk groups and can be used as a predictor for significant jaundice (area under roc curve 0.83).The feeding pattern, Kramer’s scale, TcB, urine and stool frequency were also significant (p <0.05) in these groups. Conclusion: Body weight loss percentage can predict neonatal hyperbilirubinemia in the initial 72 hours of life. Other factors were feeding pattern, urine and stool frequency.

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