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Original Article
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Abstract yperbilirubinemia is a common problem
Background Neonatal hyperbilirubinemia is commonly found LQ QHZERUQV ZKLFK PD\ GHYHORS WR
in newborns. Assessment of the risk of hyperbilirubinemia severe hyperbilirubinemia if not managed
and information on the average time of the occurrence of
properly. Early discharge of healthy-
hyperbilirubinemia are important to prevent the development of
severe hyperbilirubinemia. WHUP QHZERUQ DQG LQDGHTXDWH EUHDVWIHHGLQJ PLJKW
Objective To find out the incidence of and the time of the OHDG WR XQGHWHFWHG K\SHUELOLUXELQHPLD ZKLFK FDQ
development of hyperbilirubinemia in healthy-term newborns. FDXVH .HUQ LFWHUXV D UHHPHUJHQF\ FRQGLWLRQ
Method A cohort prospective study was done on healthy-term 7KHUHIRUHHDUO\GHWHFWLRQRIDQGDFNQRZOHGJLQJWKH
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risk factors of hyperbilirubinemia are important to
DWGLVFKDUJHGEDVHGRQ%KXWDQLQRUPRJUDP$VHULDOELOLUXELQ be conducted before discharging newborns from the
level measurement were performed within 6 days. hospital.
Results 2QH RI QHZERUQV DW ORZ ULVN JURXS GHYHORSHG %KXWDQLQRPRJUDPZKLFKZDVGHYHORSHGEDVHG
K\SHUELOLUXELQHPLD EXW GLG QRW QHHG SKRWRWKHUDS\ 6L[ RI
on postnatal age (in hours) and total serum bilirubin
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K\SHUELOLUXELQHPLD RI WKHP QHHGHG SKRWRWKHUDS\ ZLWK WRWDO OHYHOLVDQHVVHQWLDOWRROWRSUHYHQWVHYHUHK\SHUELOL-
VHUXPELOLUXELQOHYHORIPJG/DWKRXUVDQGPJG/DW rubinemia. This nomogram consists of four risk zones
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ZLWK WRWDO VHUXP ELOLUXELQ OHYHO RI PJG/ DW KRXUV
There was no newborn cathegorized as high risk group in this
zone. The incidence of severe hyperbilirubinemia
study. The median time the occurrence of hyperbilirubinemia in LQ KLJK LQWHUPHGLDWHKLJK LQWHUPHGLDWHORZ DQG
LQWHUPHGLDWHORZDQGLQWHUPHGLDWHKLJKULVNJURXSZDVKRXUV ORZ ULVN JURXSV DUH DQG
DQGKRXUVUHVSHFWLYHO\7KHUHZDVQRVLJQLILFDQWGLIIHUHQFHLQ respectively.
survival curve between intermediate-high and intermediate-low
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Conclusion The incidence of hyperbilirubinemia was not different
between intermediate-low and intermediate-high risk babies.
[Paediatr Indones. 2010;50:351-4].
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6DGLNLQ+RVSLWDO%DQGXQJ,QGRQHVLD
Keywords: neonatal hyperbilirubinemia, survival,
risk. Reprint request to$KPHG]:LGLDVWD0''HSDUWPHQWRI&KLOG+HDOWK
3DGMDMDUDQ8QLYHUVLW\+DVDQ6DGLNLQ+RVSLWDO-O3DVWHXU1R%DQGXQJ
,QGRQHVLD7HO(PDLOahmedzwidiasta@gmail.
com.
The survival analysis showed that the median and asphyxia. 1RQH RI WKH VXEMHFWV LQ WKLV VWXG\
of time of the occurrence of hyperbilirubinemia in had siblings with a history of hyperbilirubinemia.
low risk group was not able to be determined. In Previous studies showed that the incidence of severe
LQWHUPHGLDWHORZ DPG LQWHUPHGLDWH KLJK ULVN JURXS hyperbilirubinemia were found more common in
K\SHUELOLUXELQHPLD RFFXUUHG DW KRXUV DQG RI intermediate-high than intermediate-low risk zone
KRXUVUHVSHFWLYHO\&,Figure 1). and none in low risk zone. Our study showed that
hyperbilirubinemia occurred earlier in intermediate-
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the latest in low risk zone.
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Hyperbilirubinemia in this case was probably caused by
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IRUWKLVEDE\6L[RIQHZERUQVLQLQWHUPHGLDWHORZ
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Figure. 1. Survival curve in low risk, intermediate-low, SKRWRWKHUDS\ZLWKWRWDOVHUXPELOLUXELQOHYHORI
and intermediate-high risk with Gehan log-rank test. PJG/DWKRXUVLQWHUPHGLDWHKLJKULVN]RQHDQG
PJG/DWKRXUVKLJKULVN]RQHUHVSHFWLYHO\
Discussion %RWK ZHUH IHPDOHV DGHTXDWHO\ EUHDVWIHG FRPELQHG
ZLWKIRUPXODIHGPRWKHUVDJHZHUHDQG\HDUV
Hyperbilirubinemia in a healthy-term newborn was respectively. The probable causes of hyperbilirubinemia
influenced by a history of hyperbilirubinemia in were G6PD deficiency or other genetic factors. G6PD
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PRWKHULQDGHTXDWHEUHDVWIHHGLQJFHSKDOKHPDWRPD because of procedural error.