Abstract
This study was conducted to determine the incidence and magnitude of postphototherapy bilirubin rebound in neonates. Subjects included inborn neonates needing phototherapy for hyperbilirubinemia. Standard guidelines were used to start and stop phototherapy. Rebound bilirubin was measured 24±6 h after stopping phototherapy. Significant bilirubin rebound (SBR) was defined as postphototherapy bilirubin level needing reinstitution of phototherapy. Among 245 neonates with hyperbilirubinemia, post-phototherapy bilirubin estimation was done in 232 neonates. A total of 17 (7.3%) neonates developed SBR. In neonates with SBR, bilirubin increased by 2.3 mg/dL (95% CI 1.6–3.0) after stopping phototherapy. Risk factors for SBR included birth at <35 weeks of gestation (RR 4.3, 95% CI 1.5–12.0), birthweight <2000 g (RR 3.2, 95% CI 1.0–10.3) and onset of jaundice at <60 h of age (RR 3.3, 95% CI 1.2–9.0). Post-phototherapy discharge and follow-up planning should take into account these risk factors.
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References
Report 2002–2003. National Neonatal Perinatal Database Network. New Delhi: National Neonatology Forum of India; 2004.
Yetman RJ, Parks DK, Huseby V, Mistry K, Garcia J. Rebound bilirubin levels in infants receiving phototherapy. J Pediatr 1998;133:705–707.
Al-Saedi SA. Rebound hyperbilirubinemia in term infants after phototherapy. Saudi Med J 2002;23:1394–1397.
Erdeve O, Tiras U, Dallar Y. Rebound bilirubin measurement is not required for hyperbilirubinemia regardless of the background attributes of the newborns. J Trop Pediatr 2004;50:309.
Brown AK, Kim MH, Wu PY, Bryla DA. Efficacy of phototherapy in prevention and management of neonatal hyperbilirubinemia. Pediatrics 1985;75:393–400.
Maisels MJ, Kring E. Rebound in serum bilirubin level following intensive phototherapy. Arch Pediatr Adolesc Med 2002;156:669–672.
American Academy of Pediatrics. Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics 2004;114:297–316.
Tan KL, Lim GC, Boey KW. Efficacy of “highintensity” blue-light and “standard” daylight phototherapy for non-hemolytic hyperbilirubinaemia. Acta Pediatr 1992;81:870–874.
Kaplan M, Kaplan E, Hammerman C, Algur N, Bromiker R, Schimmel MS, et al. Postphototherapy neonatal bilirubin rebound: a potential cause of significant hyperbilirubinaemia. Arch Dis Child 2006;91:31–34.
Stet S, Chung M, Kulig J, O’Brien R, Sege R, Glicken S, et al. An evidence-based review of important issues concerning neonatal hyperbilirubinemia. Pediatrics 2004; 114: e130–153.
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Bansal, A., Jain, S., Parmar, V.R. et al. Bilirubin rebound after intensive phototherapy for neonatal jaundice. Indian Pediatr 47, 607–609 (2010). https://doi.org/10.1007/s13312-010-0133-z
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DOI: https://doi.org/10.1007/s13312-010-0133-z