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Direct hyperbilirubinemia in infants with congenital heart disease

Jun Fujishiro1, Masahiko Sugiyama1, Tetsuya Ishimaru1

  • 1Department of Pediatric Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.

Pediatrics International : Official Journal of the Japan Pediatric Society
|November 28, 2017
PubMed

Insights

Direct hyperbilirubinemia (D-HB) is common in infants with congenital heart disease (CHD) but usually resolves within a week. Clinical factors do not predict D-HB in these infants.

Area of Science:

  • Neonatology
  • Pediatric Cardiology
  • Bilirubin Metabolism

Background:

  • Congenital heart disease (CHD) association with infantile cholestasis, crucial for biliary atresia (BA) diagnosis, remains understudied.
  • Investigating direct hyperbilirubinemia (D-HB) characteristics in infants with CHD is essential for understanding neonatal jaundice in this population.

Purpose of the Study:

  • To characterize direct hyperbilirubinemia (D-HB) in neonates diagnosed with congenital heart disease (CHD).
  • To identify potential predictors of D-HB in infants with CHD.

Main Methods:

  • Retrospective review of neonates diagnosed with CHD between 2015-2016.
  • Analysis of direct hyperbilirubinemia (D-HB) (≥2.0 mg/dL) within 60 days of age and associated clinical parameters.
  • Statistical analysis using chi-squared or Wilcoxon rank sum tests.

Main Results:

  • 17.1% of 76 infants with CHD exhibited D-HB within 60 days.
  • Most D-HB cases (10/13) resolved spontaneously within the hospital stay, 80% within 7 days.
  • No association found between D-HB and sex, gestational age, birthweight, chromosomal anomalies, or cardiac surgical status.

Conclusions:

  • Direct hyperbilirubinemia (D-HB) is frequently observed in infants with congenital heart disease (CHD) but typically resolves rapidly.
  • Neonatal clinical parameters and CHD status do not predict D-HB development.
  • Prolonged D-HB (>1 week) in infants with CHD warrants further etiological investigation.
Abstract

Keywords:
biliary atresiacholestasiscongenital heart diseasedirect hyperbilirubinemiainfant

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