Neonatal hyperbilirubinemia at high altitude.
A previous retrospective study showed an increased frequency of neonatal hyperbilirubinemia at high altitude in Colorado. In a prospective study we found that 39% of newborns at 3100 m altitude vs 16% at 1600 m exhibited hyperbilirubinemia, defined as a day 3 serum bilirubin level of 205 mumol/L or higher. Increased bilirubin production at 3100 m vs 1600 m was shown by increased levels of corrected carboxyhemoglobin. This finding was supported by increased erythropoietin and bilirubin values in cord blood and increased hematocrit values at day 3 among infants at 3100 m vs 1600 m. The sustained elevation in bilirubin for breast-fed vs formula-fed infants at 1600 m was observed for both feeding types at 3100 m. The findings suggested that there is a hematologic response to decreased oxygen availability at high altitude, resulting in increased bilirubin production accompanied by delayed bilirubin clearance.
Department of Anthropology, University of Colorado, Denver.
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C
Leibson
M
M
Brown
S
S
Thibodeau
D
D
Stevenson
H
H
Vreman
R
R
Cohen
G
G
Clemons
W
W
Callen
L G
LG
Moore
D000328:Adult; D000531:Altitude; D001663:Bilirubin / Q000097:blood; D003120:Colorado; D005260:Female; D005312:Fetal Blood / Q000032:analysis; D006801:Humans; D007225:Infant Food; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000453:epidemiology / Q000209:etiology*; D008895:Milk, Human; D011247:Pregnancy; D012907:Smoking
D001663:Bilirubin