Conjugated hyperbilirubinemia in the neonatal intensive care unit

Turk J Gastroenterol. 2013;24(5):406-14. doi: 10.4318/tjg.2013.0553.

Abstract

Background/aims: To determine the underlying causes and short-term prognosis of patients with conjugated hyperbilirubinemia in a tertiary neonatal intensive care units.

Materials and methods: We retrospectively analyzed the etiology, course, and shortterm prognosis of conjugated hyperbilirubinemia observed in newborn infants in a tertiary neonatal intensive care units.

Results: Of a total of 104 infants with conjugated hyperbilirubinemia (2.1%, 104/4915), 92 infants (56 full-term, 36 preterm) were enrolled in the study. Cholestatic jaundice as a sole finding on physical examination during admission was present in 15.2% infants, and conjugated hyperbilirubinemia developed within the first week of life in nearly half of the infants (51.1%). The most frequent causes of conjugated hyperbilirubinemia within the first days of life were vascular/ischemic events, inspissated bile, and inherited metabolic disorders. The majority of the infants (80%) had also concomitant clinical disorders that might possibly contributed tothe development of conjugated hyperbilirubinemia. The majority of the deaths (87%) were primarily related to serious perinatal events and genetic/inherited disorders. Bilirubin levels in the most of the survivors (87.1%) returned to normal within six months.

Conclusions: Conjugated hyperbilirubinemia is not uncommon in neonatal intensive care unit. Etiology is often multifactorial and more commonly arise from non-hepatic causes. Outcome depends on the underlying causes. Early diagnosis and treatment may be critical for favorable outcome.

MeSH terms

  • Female
  • Humans
  • Hyperbilirubinemia / etiology*
  • Hyperbilirubinemia / therapy
  • Infant, Newborn
  • Intensive Care Units, Neonatal
  • Male
  • Prognosis
  • Retrospective Studies