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Incidence and risk factors of post-phototherapy neonatal rebound hyperbilirubinemia

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Abstract

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 phototherapy. 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.

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Authors and Affiliations

  1. Department of Pediatrics, Faculty of Medicine, Cairo University, Ali Basha Ebrahim, PO Box 11562, Cairo, Egypt

    Ismail Mohamed Elhawary, Eman Abdel Ghany Abdel Ghany & Walaa Alsharany Aboelhamed

  2. Department of Pediatrics, Ministry of Health, Cairo, Egypt

    Shahinaz Gamal Eldin Ibrahim

Authors
  1. Ismail Mohamed Elhawary
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  2. Eman Abdel Ghany Abdel Ghany
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  3. Walaa Alsharany Aboelhamed
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  4. Shahinaz Gamal Eldin Ibrahim
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Contributions

EIM designed the study, shared in analysis and interpretation of data, and made a critical revision of the article and final approval of the version to be published. AGEA shared data collection and interpretation of data, drafted the article and final approval for publishing; AWA shared in data acquisition and critical revision for important intellectual contents and final approval for publishing; ISHG shared in data acquisition and analysis and critical revision for important intellectual content.

Corresponding author

Correspondence to Walaa Alsharany Aboelhamed.

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Ethical approval

The study was approved by the Ethics Committee of Pediatric Department, Faculty of Medicine, Cairo University.

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There are no conflicts of interest among all authors.

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Elhawary, I.M., Abdel Ghany, E.A.G., Aboelhamed, W.A. et al. Incidence and risk factors of post-phototherapy neonatal rebound hyperbilirubinemia. World J Pediatr 14, 350–356 (2018). https://doi.org/10.1007/s12519-018-0119-9

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  • DOI: https://doi.org/10.1007/s12519-018-0119-9

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