Causes and management of hyperbilirubinemia in full-term newborns

Objective: To investigate the major causes and current management of hyperbilirubinemia in full-term newborns in a general hospital. Methods: The clinical and laboratory data of 1,455 full-term newborns with hyperbilirubinemia in the department of neonatology were collected for retrospective and descriptive analysis. Univariate logistic analysis was used to compare the risk factors for hyperbilirubinemia in these two groups (the mild-to-moderate and severe jaundice groups). The impact of feeding models (breastfeeding, formula feeding, and mixed feeding) on bilirubin metabolism in inpatients was analyzed. The severity of hyperbilirubinemia was compared in inborn and outborn groups. Results: The top three major causes of hyperbilirubinemia in hospitalized full-term newborns were jaundice of unknown cause, jaundice due to early feeding insufficiency, and breastfeeding jaundice. Comparison between the mild-to-moderate and severe jaundice groups showed that hemolytic disease of the newborn and neonatal infection were two main risk factors in the severe jaundice group (P<0.05). The top three major causes of hyperbilirubinemia in clinical consultation were breastfeeding jaundice, jaundice of unknown cause, and jaundice due to feeding insufficiency. Conclusions: Major risk factors for severe hyperbilirubinemia in full-term newborns differed between early-stage and late-stage newborns. Jaundice of unknown cause accounted for a large proportion of the cases. The causes of neonatal jaundice in clinical consultation were mostly related to the infant feeding model.