title: Evaluation of risk factors for development of severe hyperbilirubinemia in term and near term infants in Turkey.
abstract: OBJECTIVE
  To determine clinical features, etiology and risk factors in term and near term newborns with severe hyperbilirubinemia.
  
  
  METHODS
  During ten years period (2000 - 2009), infants of ≥ 35 gestational weeks who received phototherapy were evaluated retrospectively. The study population was divided into two groups and clinical features, etiology and risk factors were compared. Group 1 defined by those who had bilirubin level ≥25 mg/dl (severe hyperbilirubinemia) and group 2 defined by bilirubin level <25 mg/dl.
  
  
  RESULTS
  During the study period 1335 babies were evaluated. Severe hyperbilirubinemia was found in 137 (10.3%) patients. Total serum bilirubin level was 29.7±4.7 mg/dl in group 1 and 18.9±3.5 mg/dl in group 2. Pathological weight loss, vaginal delivery and supplementary feeding were identified as significant risk factors for development of severe hyperbilirubinemia (p <0.001, p <0.001 and p = 0.04, respectively). The time at recognition of jaundice by family and postnatal age at admission were significantly higher in group 1. The ratios of previous sibling received phototherapy and being the second child or after were found higher in group 1.
  
  
  CONCLUSIONS
  Pathological weight loss, vaginal delivery and supplementary feeding were determined as risk factors for development of severe hyperbilirubinemia. The newborns with severe hyperbilirubinemia had late recognition of jaundice and admission to hospital by their families.
authors.affiliation: Ali Bulbul, MD, Department of Pediatrics, Division of Neonatology, Sisli Hamidiye Etfal Children Hospital, Istanbul, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Bulbul
authors.affiliation: Nihal Cayonu, MD, Department of Pediatrics, Division of Neonatology, Sisli Hamidiye Etfal Children Hospital, Istanbul, Turkey.
authors.forename: Nihal
authors.initials: N
authors.lastname: Cayonu
authors.affiliation: Merve Emecen Sanli, MD, Department of Pediatrics, Division of Neonatology, Sisli Hamidiye Etfal Children Hospital, Istanbul, Turkey.
authors.forename: Merve Emecen
authors.initials: ME
authors.lastname: Sanli
authors.affiliation: Sinan Uslu, MD, Department of Pediatrics, Division of Neonatology, Sisli Hamidiye Etfal Children Hospital, Istanbul, Turkey.
authors.forename: Sinan
authors.initials: S
authors.lastname: Uslu
keywords: Feeding; Hyperbilirubinemia; Newborn; Risk factors