The Impact Of Weight Alterations On Neonatal Hyperbilirubinemia After Discharge

ObjectiveTo investigate the relationship between hyperbilirubinemia post discharge and weight alterations in mature infants. To determine the alarming line of weight alteration.MethodsThe full-term infants borned in four hospital in Beijing were involved in this study, whose bilirubin levels in the 48-72 hours after born were above 40th percentile in percentile-based bilirubin nomogram drawed by Bhurani in American, and under the level of phototherapy treatment recommended by American Academy of Pediatrics. Application and Observation of TCB (Transcutaneous Bilirubinometer) were performed at 3,7, 10and 17days postnatal and the weights were recorded. The infants were divided into two groups according to whether the bilirubin level above the 95th percentile. To determine whether the birthweight, minimum weight, weight loss speed, weight variable rate and days to regain birth weight can interfere with it’s bilirubin level. And to find the the alarming line of alteration for each of them.Results1. One hundred and one full-term infants were enrolled (hyperbilirubinemia group was 33 full-term infants and non-hyperbilirubinemia group was 68).21 full-term infants(20.8%) was hyperbilirubinemia in the five days post-natal.2. There is no difference in birthweight between the two groups. But whose birthweight between 3.5 and 4kg had a higher risk for hyperbilirubinemia than those birthweight between 3.0 and 3.5kg (p=0.024). The hyperbilirubinemia group had a high rate of weightloss (p=0.049), especially when the weight loss more than 5.1%.3. There were no difference in weight variable rate between the two groups at 3 days postnatal. But the hyperbilirubinemia group had more rapid weight loss speed (p=0.049). The full-term infants had a higher risk of hyperbilirubinemia when the rate of weightloss over 65g/d or 4.5%.4. There were no difference in weight variable rate between the two groups at 5days postnatal. But The full-term infants had a higher risk of hyperbilirubinemia when the rate of weightloss over 15.5g/d or 2.1%.5. There were no difference in the days to regain birth weight between the two groups. But the hyperbilirubinemia group had more slowly speed than the non-hyperbilirubinemia group.ConclusionThe full-term infants also had the risk of hyperbilirubinemia post discharge. And the risk of hyperbilirubinemia had the relationship with the weight alterations.It was important to observe the baby’s bilirubin level when the baby had excessive weight loss or too slow to regain birth weight for prevention and management of hyper-bilirubinemia in time.