Incidence and causes of neonatal hyperbilirubinemia in a center of Catania.
OBJECTIVE
We conducted this study to estimate the incidence of hyperbilirubinemia in a small neonatal care unit in Catania, Italy, and to determine the underlying causes, which would be of value in identifying and implementing strategies to prevent morbidity from this condition.


BACKGROUND
Management of hyperbilirubinemia remains a challenge for neonatal medicine because of the risk for serious neurological complications related to the toxicity of bilirubin.


METHODS
From January 2006 to January 2007, we screened 525 newborns born at the Neonatal Care Unit of Valsalva Hospital in Catania, Italy. Infants aged 3-5 days and with unconjugated hyperbilirubinemia were included for assessment if they had a peak serum total bilirubin level exceeding 6 mg/dl (102 mumol/L). Sex, birth weight, gestational age, breast feeding, type of birth, presence of facial bruising (including cephalohematoma) and ABO group were noted. Patients with Toxoplasma or Cytomegalovirus infection, hepatic insufficiency, or suspected drug-induced hyperbilirubinemia were excluded from more detailed analysis.


RESULTS
Our year-long nursery sample examined otherwise healthy-appearing term infants for the prevalence of hyperbilirubinemia (defined as bilirubin levels exceeding 6 mg/dL [11mol/L]). We found hyperbilirubinemia in 19% (100/525). Among the patients with hyperbilirubinemia, almost all (99%) had peak levels of bilirubin <20 mg/dL, levels which are generally considered to be potentially neurotoxic.


CONCLUSIONS
In our clinic experience, hyperbilirubinemia was generally a serious medical issue and one whose etiology can usually be well defined.
Neonatal Care Section, Valsalva Hospital, Catania, Italy;
Marco
M
Sciuto
Gaetano
G
Bertino
Mariangela
M
Zocco
Ignazio
I
Vecchio
Rocco
R
Raffaele
Rosario R
RR
Trifiletti
Piero
P
Pavone