Related Experiment Video
Updated: Aug 1, 2026
Biochemical Measurement of Neonatal Hypoxia
Published on: August 24, 2011
Extreme hyperbilirubinaemia in term and near-term infants in Denmark
F Ebbesen1, C Andersson, H Verder
1Department of Paediatrics, Aalborg University Hospital, Denmark. u19091@aas.nja.dk
Insights
Extreme hyperbilirubinaemia affects 25 per 100,000 infants born at term. Most cases occurred in hospitalized infants, but those treated at home showed more central nervous system involvement.
Area of Science:
- Neonatal medicine
- Pediatric endocrinology
- Public health
Background:
- Extreme hyperbilirubinaemia in term and near-term infants poses significant health risks.
- Timely intervention is crucial to prevent severe neurological complications.
- Understanding the incidence and risk factors is vital for public health strategies.
Purpose of the Study:
- To determine the incidence of extreme hyperbilirubinaemia in infants born at term or near-term.
- To identify infants with serum bilirubin levels exceeding exchange transfusion thresholds.
- To assess the neurological involvement and treatment outcomes in affected infants.
Main Methods:
- A 2-year retrospective study (2000-2001) in Denmark.
- Inclusion of all live-born term or near-term infants with extreme hyperbilirubinaemia.
- Data collection on serum bilirubin levels, neurological symptoms, and treatment.
Main Results:
- An incidence of 25 per 100,000 infants was observed.
- Twelve infants exhibited signs of central nervous system involvement, including acute bilirubin encephalopathy.
- Infants admitted from home had later peak total serum bilirubin (TSB) and more frequent neurological symptoms.
Conclusions:
- Extreme hyperbilirubinaemia occurs in 25 per 100,000 term/near-term infants.
- The majority of cases developed while hospitalized.
- Infants treated after discharge from home showed increased risk of central nervous system involvement.
Aim:
To determine the incidence amongst infants born at term or near-term of extreme hyperbilirubinaemia, i.e., with a serum concentration of unconjugated bilirubin exceeding the limit above which an exchange transfusion was indicated according to the authorized guidelines.
Method:
The investigation period covered 2 y, 1 January 2000 to 31 December 2001, and included all infants born alive at term or near-term in Denmark. All infants with extreme hyperbilirubinaemia admitted to paediatric departments were recorded.
Results:
Thirty-two infants developed extreme hyperbilirubinaemia, i.e., an incidence of 25 per 100 000. The maximum total serum bilirubin concentration (TSB) was 492 (385-689) micromol/I (median (range)). The median value of the exchange transfusion limits was 450 micromol/l. Twelve infants had signs and symptoms of central nervous system involvement; 11 had acute bilirubin encephalopathy phase-1 symptoms; and one had phase-2 symptoms. Nineteen infants developed extreme hyperbilirubinaemia during primary admission to the maternity ward or neonatal department; the others after having been discharged. There was no difference in maximum TSB between those infants not discharged from hospital and those infants admitted to hospital from home. Maximum TSB appeared latest amongst those infants admitted from home (p < 0.01), and these more often had signs and symptoms of central nervous system involvement (p < 0.05). Ten infants were of non-Caucasian extraction. Less than half of all Danish mothers receive both verbal and written information after birth on jaundice in the infant.
Conclusion:
Twenty-five per 100 000 infants born at term or near-term developed extreme hyperbilirubinaemia, the majority of them whilst in hospital. Infants admitted from home more often had signs and symptoms of central system involvement.
