Risk factors for acute bilirubin encephalopathy in full-term infants - a multicenter study

Objective: The purpose of this study was to evaluate the neurotoxicity risk factors in predicting acute bilirubin encephalopathy (ABE) at admission in infants with severe hyperbilirubinemia. Methods: We analyzed the general clinical data and risk factors as determinants of ABE in a total of 329 full-term newborns treated with total serum bilirubin (TSB) at a level of 20 mg/dL (342 mu mol/L) to 7 neonatal intensive care units in Hebei Province, China over the past 18 months. Results: Admission of TSB level ranged from 20 to 56.2 mg/dL. There were 13 newborns (4.0%) of subtle ABE at admission and 22 newborns (6.7%) of moderate or severe ABE at admission. Twelve infants (3.6%) had evidence of bilirubin encephalopathy (BE) at the time of follow-up. Sepsis (OR: 17.05) greatly increased the risk for ABE, and TSB and bilirubin to albumin ratio (B/A) level were risk factors of adverse outcome in logistic regression (OR: 1.009, 1.308, respectively). Conclusions: TSB, B/A and sepsis are risk factors for ABE.

Automated summary

This study identified sepsis, TSB, and B/A ratio as risk factors for predicting acute bilirubin encephalopathy (ABE).