Predictors of Acute Bilirubin Encephalopathy Among Nigerian Term Babies With Moderate-To-Severe Hyperbilirubinaemia

J Trop Pediatr. 2011 Apr;57(2):80-6. doi: 10.1093/tropej/fmq045. Epub 2010 Jun 15.

Abstract

Objective: To determine predictors of acute bilirubin encephalopathy (ABE) among term infants presenting with moderate-to-severe hyperbilirubinaemia.

Methods: Babies with total serum bilirubin >15 mg/dl at the point of admission were studied in a Nigerian tertiary health facility using bivariate and multivariate analysis.

Results: Out of 152 babies, 75 (49.3%) had ABE: 73 had ABE at presentation while two developed ABE after admission. Bivariate analysis showed that body weight <2.5 kg, outside delivery, low maternal education, low socio-economic status, severe anaemia, glucose-6-phosphate dehydrogenase deficiency and metabolic acidosis were significantly associated with ABE. Multivariate analysis also showed that only outside delivery, weight <2.5 kg, presence of severe anaemia and acidosis were the predictors of ABE in this cohort of term babies.

Conclusion: The identified predictors of ABE are modifiable and can be used to draw up screening tools for term babies at risk of ABE especially in the developing world.

MeSH terms

  • Acidosis / metabolism
  • Acute Disease
  • Bilirubin / blood*
  • Female
  • Gestational Age
  • Glucosephosphate Dehydrogenase / metabolism
  • Hospitalization
  • Hospitals, Teaching
  • Humans
  • Hyperbilirubinemia / complications
  • Hyperbilirubinemia / epidemiology*
  • Hyperbilirubinemia / prevention & control
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / epidemiology*
  • Infant, Premature, Diseases / prevention & control
  • Kernicterus / diagnosis*
  • Male
  • Multivariate Analysis
  • Nigeria / epidemiology
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Socioeconomic Factors

Substances

  • Glucosephosphate Dehydrogenase
  • Bilirubin