title: Total serum bilirubin level in umbilical cord blood and respiratory distress syndrome in very low birth weight infants.
abstract: OBJECTIVE
  To explore the association between total serum bilirubin (TSB) level in umbilical cord blood (UCB) and the occurrence and/or severity of respiratory distress syndrome (RDS) in very low birth weight (VLBW) infants.
  
  
  METHODS
  We performed a prospective study of 579 VLBW infants. The mean TSB level in UCB (1.8 mg/dL) was used to divide the cohort into two groups: neonates with levels <1.8 mg/dL and those with levels >1.8 mg/dL. Demographic and clinical characteristics of the 2 groups, including diagnosis of RDS, need for ventilation, peak fraction of inspired oxygen (FiO2), oxygenation index (OI), and duration of respiratory support, were compared.
  
  
  RESULTS
  Three hundred and twenty-four infants were included in the low-TSB group and 255 infants were included in the high-TSB group. RDS was less frequent in the high TSB group than in the low one (46.3% vs. 56.6%, P=0.01). A negative association between TSB level in UCB and the occurrence of RDS [odds ratio (OR)=0.620; 95% confidence interval (CI) 0.440-0.873, P=0.006] was observed. However, lower TSB in UCB was not associated with the maximum FiO2, OI, or duration of mechanical ventilation.
  
  
  CONCLUSIONS
  VLBW infants with low TSB levels in UCB were more likely to develop RDS. However, in conjunction with surfactant replacement therapy, no correlation was found between TSB levels in UCB and the severity of RDS. The negative association between high TSB in UCB and RDS warrants further investigation.
authors.affiliation: Department of Neonatology, Children's Hospital, Zhejiang University, School of Medicine, Hangzhou 310003, China.
authors.forename: Jiajun
authors.initials: J
authors.lastname: Zhu
authors.forename: Yanping
authors.initials: Y
authors.lastname: Xu
authors.forename: Guolian
authors.initials: G
authors.lastname: Zhang
authors.forename: Mingyuan
authors.initials: M
authors.lastname: Wu
authors.forename: Lizhong
authors.initials: L
authors.lastname: Du
mesh_terms: D001663:Bilirubin / Q000097:blood*; D005260:Female; D005312:Fetal Blood / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000097:blood; D008297:Male; D011446:Prospective Studies; D012127:Respiratory Distress Syndrome, Newborn / Q000097:blood*
chemical_list: D001663:Bilirubin