Prediction of Hyperbilirubinemia in Term Infants

Background and aims: Recognition of neonates with high risk for significant hyperbilirubinemia is important. The aim of this study was to investigate the risk factors for significant hyperbilirubinemia in term infants.

Methods: A prospective cohort study was conducted to investigate the effects of birth weight, gestational age, sex, mode of delivery and feeding, glucose-6-phosphate dehydrogenase deficiency, variant UDP-glucuronosyltransferase 1A1 (UGT1A1) gene, and solute carrier organic anion transporter 1B1 (SLCO1B1) gene on hyperbilirubinemia. The PCR- restriction fragment length polymorphism (RFLP) method was applied to detect the known variant sites in the UGT1A1and SLCO1B1 gene. Significant hyperbilirubinemia was defined as a bilirubin level exceeding the hour-specific phototherapy threshold. We analyzed the risk factors for significant hyperbilirubinemia using univariate logistic regression models.

Results: Totally 293 term infants (144 males and 149 females) were enrolled in this study. Thirty one (22 males and 9 females) had significant hyperbilirubinemia. The statistically significant risk factors for jaundice were G6PD deficiency (37.38; 95% CI, 4.58 to 305.22; P=0.001), the 211 G to A variation in the UGT1A1 gene (3.09; 95% CI, 1.23 to 7.74; P =0.016), vaginal delivery (3.36; 95% CI, 1.12 to 10.05; P=0.03), breast feeding (4.91; 95% CI, 1.64 to 14.70; P=0 .004), male (2.89; 95% CI, 1.104 to 7.55; P=0 .031) and gestational age (0.46; 95% CI, 0.29 to 0.73; P =0.001).

Conclusion: The infants who are G6PD deficiency, carry the 211 variants in the UGT1A1, vaginal delivery, low gestational age, male and breast feeding are at high risk to develop severe hyperbilirubinemia.