Rebound hyperbilirubinemia in term infants after phototherapy.
OBJECTIVE
To determine whether a rebound in serum bilirubin level occurs within 24 hours after discontinuation of phototherapy in term infants with hyperbilirubinemia.


METHODS
A retrospective medical record review of term infants with hyperbilirubinemia requiring phototherapy who were admitted over 24 months, June 1999 to December 2001, at King Abdul-Aziz University Hospital, Jeddah, Kingdom of Saudi Arabia was completed. Total serum bilirubin levels (TSB) at and up to 24 hours after termination of phototherapy (follow-up levels) were recorded. The difference between mean TSB level at termination of phototherapy and at follow-up was calculated using the paired t test.


RESULTS
Three hundred and one infants, 53% (n=161) were boys, mean standard deviation (SD) for gestational age was 39.4 +/- 1.4 weeks, mean birth weight was 3200 +/- 600 g, mean TSB SD at termination of phototherapy was 193 +/- 46 micromole/liter (micromol/l) and at follow-up was 188 +/- 45 micromol/l for all infants with either positive or negative direct coombs' test results. The difference in mean TSB level at discontinuation of phototherapy and at follow-up was statistically significant, (t=3.12, P=0.002). The mean TSB level at termination of phototherapy was 179 +/- 47 micromol/l and at follow-up was 177 +/- 47 micromol/l for 65 infants with positive direct coombs' test results. This difference was statistically insignificant (t=0.725, P=0.47). The mean time interval between the termination of phototherapy and the measurement of follow-up TSB level was 8.3 +/- 5.3 hour.


CONCLUSIONS
The rebound of bilirubin level after termination of phototherapy in otherwise healthy term infants is minimal; thus measurement of serum bilirubin is not required after termination of phototherapy and adds unnecessary expense, prolongs hospitalization, or both.
Al-Saedi
Saad A
SA
Department of Pediatrics, King Abdul-Aziz University Hospital, PO Box 80215, Jeddah 21589, Kingdom of Saudi Arabia. salsaedi@hotmail.com
D005260:Female; D005865:Gestational Age; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000209:etiology* / Q000628:therapy*; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D010789:Phototherapy; D012008:Recurrence; D012189:Retrospective Studies