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Incidence and risk factors of post-phototherapy neonatal rebound hyperbilirubinemia

World Journal of Pediatrics 2018年第4期14卷 350-356页

作者： Ismail Mohamed Elhawary Eman Abdel Ghany Abdel Ghany Walaa Alsharany Aboelhamed shahinaz gamal eldin ibrahim Department of Pediatrics Faculty of MedicineCairo UniversityAli Basha EbrahimPO Box 11562CairoEgypt Department of Pediatrics Ministry of HealthCairoEgypt

Background To determine the incidence and risk factors of post-phototherapy rebound hyperbilirubinemia because data about bilirubin rebound in neonates are lacking and few studies have concerned this condition. Methods A prospective observational study was conducted on 500 neonates with indirect hyperbilirubinemia who were treated according to standard guidelines. Total serum bilirubin (TSB) was measured at 24–36 h after phototherapy;significant bilirubin rebound (SBR) is considered as increasing TSB that needs reinstitution of phototherapy. Results A total of 124 (24.9%) neonates developed SBR with TSB increased by 3.4 (2.4–11.2) mg/dL after stopping pho-totherapy. Multiple logistic regression model revealed the following significant risk factors for rebound: low birth weight (B = 1.3,P < 0.001, OR 3.5), suspected sepsis (B = 2.5,P < 0.001, OR 12.6), exposure to intensive phototherapy (B = 0.83, P= 0.03, OR 2.3), hemolysis (B = 1.2,P < 0.001, OR 3.1), high discharge bilirubin level (B = 0.3,P = 0.001, OR 1.3), and short duration of conventional phototherapy (B = ? 1.2,P < 0.001, OR 0.3). Conclusions SBR should be considered in neonates with hemolysis, low birth weight, suspected sepsis, short duration of conventional phototherapy, exposure to intensive phototherapy, and relatively high discharge TSB. These risk factors should be taken into account when planning post-phototherapy follow-up.

关键词： Conventional phototherapy Hemolysis Intensive phototherapy Neonatal hyperbilirubinemia Rebound hyperbilirubinemia

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