Serum bilirubin trend, hematological and clinical profile of late preterm and term neonates with unconjugated hyperbilirubinemia - A prospective observational study

Abstract

Background: Studies comparing serum bilirubin trend and hematological profile of neonates with hemolytic and nonhemolytic etiology are limited. Apart from high bilirubin load, they are at increased risk of developing anemia in early days of life. Methods: A prospective observational study was conducted in neonatal unit on late preterm and term neonates (>35 weeks) with unconjugated hyperbilirubinemia (UH) to compare serum bilirubin trend (initial and peak), hematological profile (hemoglobin [Hb] and hematocrit [PCV]) (initial and at 3 months), between hemolytic and non-hemolytic cases. Result: Among 240 enrolled neonates, initial serum bilirubin level was higher in haemolytic group than non-hemolytic (mg/dl) (16.9 ± 3.2 vs. 14.6 ± 4.1; p < 0.001), while peak bilirubin were similar. Initial Hb (g/dl) (13.0 ± 3.2 vs. 14.4 ± 3.4; p = 0.001), PCV (44.9 ± 8.7 vs. 51.2 ± 5.9; p = 0.001) were significantly lower in haemolytic group than non-hemolytic group. At 3 months of age, Hb (g/dl) (10.9 ± 1.8 vs. 11.7 ± 1.4; p = 0.002), PCV (31.0 ± 4.9 vs. 34.2 ± 2.9; p = 0.001) were lower in hemolytic group. Conclusions: Neonates with UH due to haemolytic causes had significantly high initial bilirubin; lower Hb at admission. Hb was significantly low at 3 months follow up too requiring more number of transfusions. Therefore anaemia, not only at admission but also in follow up should be an important concern for such neonates to be vigilant for.

Keywords

• Hematological profile
• Late preterm
• Near term neonates
• Serum bilirubin trend
• Unconjugated hyperbilirubinemia