Incidence and Risk Factors of Post-phototherapy Neonatal Bilirubin Rebound

Abstract

Incidence and Risk Factors of Post-phototherapy Neonatal Bilirubin Rebound

Manutham Manavathongchai MD*

Payon Boonyarittipong MD*

Ariya Sanguanwongthong MD*

Kannikar Booranavanich MD*

Siwiluck Kanchanabat MD*

Vip Viprakasit MD, PhD**

* Department of Pediatrics, BMA Medical College and Vajira Hospital

**Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University

Objectives: To determine the incidence and risk factors of post-phototherapy neonatal bilirubin rebound.

Study design: Cross-sectional study.

Subjects: A total of two hundred and two term newborns with hyperbilirubinemia received phototherapy at Department of Pediatrics, BMA Medical College and Vajira Hospital during May to December 2006 were recruited. Bilirubin level at 24 hours after the phototherapy was assessed in all patients.

Methods: Demographic data, bilirubin level and all possible risk factors associated with rebound hyperbilirubinemia were collected and analyzed.

Main outcome measures: Incidence and risk factors of post-phototherapy neonatal bilirubin rebound.

Results: A total of 10 neonates (4.9%) developed significantly rebound hyperbilurubinemia. All of them were treated with phototherapy again. An initial age of phototherapy (less than 48 hrs.) was the only significant risk factor contributing to rebound hyperbilirubinemia (odds ratio 6.3, 95% CI: 1.6-25.2).

Conclusion: Rebound hyperbilirubinemia after complete phototherapy session was not common in term neonates. However, newborns having an early onset of jaundice within 48 hrs. requiring immediate phototherapy had more chance to develop rebound phenomenon.

Vajira Med J 2007 ; 51 : 25 - 32