Etiologies of severe indirect hyperbilirubnemia in term neonates, Gorgan - Iran

Jaundice is a common problem among neonate undiagnosed case finally lead to kern-icterus, with significant increasing rate of subsequent morbidity. This study was done to determine the etiology of of severe indirect hyperbilirubnemia in term neonates.

This cross sectional descriptive study was performed in Taleghany hospital of Gorgan on neonates admitted due to severe hyperbilirubinemia from Sep 2004-Sep 2005. Severe hyperbilirubinemia was considered as bilirubin≥18 mg/dl in term neonates weighing more than 2500g. Bilirubin (total, direct), blood culture, retic count, coombs test, level of glucose 6 phosphate dehydrogenase enzyme, complete blood cell count, mother's and neonate's blood group, urine culture and C-reactive protein tests were measured.

766 term neonates (>2500g) were hospitalized due to hyperbilirubinemia. Severe hyperbilirubinemia was detected in 12% of cases (54 boys, 38 girls). The etiology of 41 cases were unknown, 25 cases were diagnosed as sepsis, 15 neonates were glucose 6 phosphate dehydrogenase enzyme deficient, 7 cases had UTI, 3 neonates had ABO incompatibility and one neonate was due to breast feeding.

This study indicated that the most common etiology of severe hyperbilirubinemia in this region is unknown. Sepsis, glucose 6 phosphate dehydrogenase enzyme deficiency, UTI, ABO incompatibility and breast feeding were among other reasons for severe indirect hyperbilirubinemia.