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Prospective surveillance study of severe hyperbilirubinaemia in the newborn in the UK and Ireland
Donal Manning1, Peter Todd, Melanie Maxwell
1Donal Manning, Department of Paediatrics, Arrowe Park Hospital, Wirral, Merseyside CH49 5PE, UK. donal.manning@whnt.nhs.uk
Insights
Severe hyperbilirubinaemia affects 7.1/100,000 UK newborns, with male infants and those of ethnic minority origin being more susceptible. This study identified key risk factors and outcomes for neonatal jaundice.
Area of Science:
- Neonatal Medicine
- Pediatric Gastroenterology
- Public Health
Background:
- Severe hyperbilirubinaemia is a significant concern in newborns.
- Understanding its incidence and associated factors is crucial for timely intervention.
Purpose of the Study:
- To determine the incidence of severe hyperbilirubinaemia in newborns.
- To identify associated clinical and demographic variables.
- To assess short-term outcomes.
Main Methods:
- A prospective, population-based study was conducted.
- Data were collected from infants in the UK and Republic of Ireland between May 2003 and May 2005.
- Severe hyperbilirubinaemia was defined as unconjugated serum bilirubin >/=510 micromol/l.
Main Results:
- The UK incidence of severe hyperbilirubinaemia was 7.1/100,000 live births.
- Male infants (60.4%) and those of ethnic minority origin (51.8%) were disproportionately affected.
- Bilirubin encephalopathy occurred in 14 infants, with 3 deaths.
Conclusions:
- This is the first large, prospective, population-based study on severe neonatal hyperbilirubinaemia.
- Identified clinical and demographic associations align with previous North American and European findings.
- Findings underscore the importance of monitoring and managing neonatal jaundice.
Objectives:
To determine the incidence of severe hyperbilirubinaemia in the newborn, and to identify associated clinical and demographic variables, and short-term outcomes.
Design:
Prospective, population-based study.
Setting:
UK and Republic of Ireland, between 1 May 2003 and 31 May 2005.
Participants:
Infants in the first month of life with severe hyperbilirubinaemia (maximum unconjugated serum bilirubin >/=510 micromol/l).
Results:
108 infants met the case definition, 106 from the UK and 2 from the Republic of Ireland. The UK incidence of severe hyperbilirubinaemia was 7.1/100 000 live births (95% CI 5.8 to 8.6). Only 20 cases presented in hospital; 88 were admitted with severe jaundice. 64 (60.4%) cases were male, and 56 (51.8%) were of ethnic minority origin. 87 (80.5%) cases were exclusively breast fed. Co-morbidity included haemolysis, dehydration, infection and bruising. 14 infants showed evidence of bilirubin encephalopathy, of whom 3 died. The UK incidence of bilirubin encephalopathy was 0.9/100 000 live births (95% CI 0.46 to 1.5).
Conclusions:
This is the first large, prospective, population-based study of the incidence of severe hyperbilirubinaemia in the newborn. The clinical and demographic associations, and short-term outcomes identified, are the same as those reported recently in North America and Europe.
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