Etiological analyses of marked neonatal hyperbilirubinemia in a single institution in Taiwan

Shao Wen Cheng, Ya Wen Chiu, Yi Hao Weng

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: Hyperbilirubinemia is a common disorder during the neonatal period. Severe neonatal hyperbilirubinemia (NH) carries a potential for permanent neurological impairment. The current study analyzed possible etiologies leading to NH. Methods: A retrospective cohort of neonates with total serum bilirubin (TSB) > 20 mg/dL was surveyed from 1995 to 2007. Subjects with gestational ages <34 weeks were excluded, leaving a total of 413 enrolled neonates. Results: The most common etiology in relation to marked NH was breast milk feeding (38.5%), followed by glucose-6-phospahate dehydrogenase (G6PD) deficiency (24.0%), ABO incompatibility (21.8%), extravascular hemorrhage (6.5%), Rh incompatibility (2.9%), bacterial infection (2.2%), hereditary spherocytosis (1.2%), dehydration (1.2%), diabetic mother (1.0%), polycythemia (0.7%), and gastrointestinal obstruction (0.7%). Other rare etiologies included Down syndrome, Chinese herb intake, asphyxia, galactosemia and congenital hypothyroidism. We did not identify any known cause in 63 neonates (15.3%). Neonates with more than one etiology tended to have higher TSB than subjects without a known etiology (p <0.05). Anemia was more common in those with G6PD deficiency, blood group incompatibility, hereditary spherocytosis, and gastrointestinal obstruction. Neonates fed breast milk tended to have prolonged NH. Conclusion: This study depicts the clinical features of marked NH. Breast milk feeding, G6PD deficiency and ABO incompatibility are common etiologies in Taiwan. Prolonged NH is more common in neonates fed breast milk than those who were given formula.

Original languageEnglish
Pages (from-to)148-154
Number of pages7
JournalChang Gung Medical Journal
Volume35
Issue number2
Publication statusPublished - Mar 2012

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Neonatal Hyperbilirubinemia
Taiwan
Human Milk
Hereditary Spherocytosis
Oxidoreductases
Breast Feeding
Bilirubin
Glucose
Galactosemias
Blood Group Incompatibility
Congenital Hypothyroidism
Polycythemia
Hyperbilirubinemia
Asphyxia
Down Syndrome
Serum
Dehydration
Bacterial Infections
Gestational Age
Anemia

Keywords

  • Blood group incompatibility
  • Breast milk
  • G6PD deficiency
  • Neonatal hyperbilirubinemia
  • Total serum bilirubin

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Etiological analyses of marked neonatal hyperbilirubinemia in a single institution in Taiwan. / Cheng, Shao Wen; Chiu, Ya Wen; Weng, Yi Hao.

In: Chang Gung Medical Journal, Vol. 35, No. 2, 03.2012, p. 148-154.

Research output: Contribution to journalArticle

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abstract = "Background: Hyperbilirubinemia is a common disorder during the neonatal period. Severe neonatal hyperbilirubinemia (NH) carries a potential for permanent neurological impairment. The current study analyzed possible etiologies leading to NH. Methods: A retrospective cohort of neonates with total serum bilirubin (TSB) > 20 mg/dL was surveyed from 1995 to 2007. Subjects with gestational ages <34 weeks were excluded, leaving a total of 413 enrolled neonates. Results: The most common etiology in relation to marked NH was breast milk feeding (38.5{\%}), followed by glucose-6-phospahate dehydrogenase (G6PD) deficiency (24.0{\%}), ABO incompatibility (21.8{\%}), extravascular hemorrhage (6.5{\%}), Rh incompatibility (2.9{\%}), bacterial infection (2.2{\%}), hereditary spherocytosis (1.2{\%}), dehydration (1.2{\%}), diabetic mother (1.0{\%}), polycythemia (0.7{\%}), and gastrointestinal obstruction (0.7{\%}). Other rare etiologies included Down syndrome, Chinese herb intake, asphyxia, galactosemia and congenital hypothyroidism. We did not identify any known cause in 63 neonates (15.3{\%}). Neonates with more than one etiology tended to have higher TSB than subjects without a known etiology (p <0.05). Anemia was more common in those with G6PD deficiency, blood group incompatibility, hereditary spherocytosis, and gastrointestinal obstruction. Neonates fed breast milk tended to have prolonged NH. Conclusion: This study depicts the clinical features of marked NH. Breast milk feeding, G6PD deficiency and ABO incompatibility are common etiologies in Taiwan. Prolonged NH is more common in neonates fed breast milk than those who were given formula.",
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