title: Identifying term breast-fed infants at risk of significant hyperbilirubinemia.
abstract: BACKGROUND
  The aim of this study was to establish a model to identify term breast-fed infants who are at risk of developing significant neonatal hyperbilirubinemia.
  
  
  METHODS
  A prospective study was designed to investigate the effects of birth weight, mode of delivery, cephalohematoma, glucose-6-phosphate dehydrogenase (G6PD) deficiency, predischarge total serum bilirubin, variant uridine 5'diphospho-glucuronosyltransferase 1A1 (UGT1A1) gene, and hepatic solute carrier organic anion transporter 1B1 (SLCO1B1) gene on significant hyperbilirubinemia in term breast-fed neonates. Significant hyperbilirubinemia was defined as a bilirubin level exceeding the hour-specific phototherapy treatment threshold recommended by the American Academy of Pediatrics in 2004.
  
  
  RESULTS
  Of 240 exclusively breast-fed term neonates, 26 (10.8%) had significant hyperbilirubinemia. The predischarge total serum bilirubin on the third day (odds ratio (OR) = 2.63; 95% confidence interval (CI): 1.87-3.70; P < 0.001) and the variant UGT1A1 gene at nucleotide 211 (OR = 5.00; 95% CI: 1.08-23.03; P < 0.05) were significant risk factors. The area under the receiver operating characteristic (ROC) curve of the predictive probability was 0.964 (95% CI: 0.932-0.984; P < 0.0001).
  
  
  CONCLUSIONS
  Combining the total serum bilirubin on the third day and the variant UGT1A1 gene at nucleotide 211 can predict hyperbilirubinemia well in term breast-fed infants.
authors.affiliation: 1] Department of Pediatrics, Far Eastern Memorial Hospital, Pan-Chiao, New Taipei, Taiwan [2] Oriental Institute of Technology, Pan-Chiao, New Taipei, Taiwan.
authors.forename: Pi-Feng
authors.initials: PF
authors.lastname: Chang
authors.forename: Yu-Cheng
authors.initials: YC
authors.lastname: Lin
authors.forename: Kevin
authors.initials: K
authors.lastname: Liu
authors.forename: Shu-Jen
authors.initials: SJ
authors.lastname: Yeh
authors.forename: Yen-Hsuan
authors.initials: YH
authors.lastname: Ni
mesh_terms: D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000378:metabolism*; D001724:Birth Weight; D001942:Breast Feeding / Q000009:adverse effects*; D036861:Delivery, Obstetric; D005260:Female; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000378:metabolism; D014453:Glucuronosyltransferase / Q000235:genetics; D006801:Humans; D006932:Hyperbilirubinemia / Q000453:epidemiology* / Q000209:etiology*; D007223:Infant; D027381:Liver-Specific Organic Anion Transporter 1; D008297:Male; D016017:Odds Ratio; D027361:Organic Anion Transporters / Q000235:genetics; D011446:Prospective Studies; D012307:Risk Factors; D000099148:UGT1A1 Enzyme
chemical_list: D001663:Bilirubin; D015415:Biomarkers; D014453:Glucuronosyltransferase; D027381:Liver-Specific Organic Anion Transporter 1; D027361:Organic Anion Transporters; D000099148:UGT1A1 Enzyme; C503999:SLCO1B1 protein, human