Affiliations: [a] Department of Pediatrics, Almana General Hospital, Al-Ahsa, Saudi Arabia
| [b] Department of Pediatrics, King Abdulaziz Hospital, Ministry of National Guard Hospital, Al-Ahsa, Saudi Arabia
| [c] Department of Pediatrics, Oasis Hospital, Al-Ain, United Arab Emirates
Address for correspondence: Dr. Sameer Y. Al Abdi, Department of Pediatrics, King Abdulaziz Hospital, Ministry of National Guard Hospital, PO Box 2477 Al-Ahsa 31982 Saudi Arabia.Tel.: +966 593333/Ext. 33386; Fax: +966 593333/Ext. 33844; E-mail: [email protected].
Abstract: BACKGROUND: Hyperbilirubinemia is one of the most common causes of neonatal readmission to hospital. AIMS: To assess risk factors for hyperbilirubinemia among neonates readmitted for this condition and the ratio of the mean corpuscular hemoglobin concentration (MCHC) to the mean corpuscular volume (MCV). METHODS: We retrospectively studied the clinical and laboratory findings, management and possible risk factors for hyperbilirubinemia in 301 neonates born at ≥35 weeks gestation and readmitted to hospital owing to hyperbilirubinemia over five years. RESULTS: No risk factors for hyperbilirubinemia were identified in 64 (21.3%) neonates, and one or more risk factors were found in 237 neonates (78.7%). The most prevalent risk factor (41.9%) was G6PD deficiency, which occurred in 11 of the 15 neonates with a serum bilirubin level ≥427 μmol/l. A double-volume exchange blood transfusion was performed in two neonate boys in whom G6PD deficiency was the single risk factor for hyperbilirubinemia. One of them developed kernicterus later. The MCHC/MCV ratio of neonates with idiopathic hyperbilirubinemia, unexplained hemolysis, or other risk factors overlapped. CONCLUSIONS: This study confirmed that in an area where G6PD deficiency is prevalent, it is the most common and most severe risk factor for hyperbilirubinemia. This finding supports routine neonatal screening for G6PD deficiency in such areas. The usefulness of determining the MCHC/MCV ratio in the management of hyperbilirubinemia is uncertain.