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Neonatal Jaundice in Preterm Infants with Bilirubin Encephalopathy

Akihisa Okumura1, Shintaro Ichimura2, Masahiro Hayakawa3

  • 1Department of Pediatrics, Aichi Medical University, Nagakute, Japan, okumura.akihisa.479@mail.aichi-med-u.ac.jp.

Neonatology
|March 21, 2021
PubMed

Insights

Bilirubin encephalopathy (pBE) in preterm infants often presents without high total bilirubin levels or bilirubin/albumin ratios, with peaks sometimes delayed beyond four weeks. Treatment involved phototherapy and exchange transfusions.

Area of Science:

  • Neonatal Medicine
  • Pediatric Neurology
  • Biochemistry

Background:

  • Bilirubin encephalopathy (pBE) is a serious concern in preterm infants.
  • Understanding bilirubin parameters and treatment is crucial for managing pBE.

Purpose of the Study:

  • To clarify key bilirubin parameters in preterm infants with pBE.
  • To analyze treatment strategies, including phototherapy and exchange transfusion, for pBE.

Main Methods:

  • Data collected from 75 preterm infants diagnosed with pBE across 58 hospitals in Japan.
  • Analysis of serum total bilirubin (TB), direct bilirubin (DB), albumin, and unbound bilirubin (UB) levels within the first 8 weeks of life.
  • Review of phototherapy and exchange transfusion treatments administered.

Main Results:

  • Average peak TB: 12.6 mg/dL; average age at peak: 19.7 days.
  • Low albumin (<2.5 g/dL) in 44 patients; elevated peak DB (≥2 mg/dL) in 20 patients.
  • Average peak bilirubin/albumin ratio: 3.8; average peak UB: 0.67 μg/dL. Peak TB occurred after phototherapy in 30/61 infants.

Conclusions:

  • Many pBE cases show normal or mildly elevated TB levels and bilirubin/albumin ratios.
  • Peak bilirubin levels can be delayed, occurring after 4 weeks of age in some preterm infants.
Abstract

Keywords:
AlbuminPhototherapyTotal bilirubinUnbound bilirubin

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