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Predicting significant hyperbilirubinaemia using birth weight
  1. V J Flaherman1,
  2. A Ferrara2,3,
  3. T B Newman1,2,4
  1. 1
    Division of General Pediatrics, University of California, San Francisco, California, USA
  2. 2
    Division of Research, Kaiser Permanente Medical Care Program, Oakland, California, USA
  3. 3
    Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA
  4. 4
    Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
  1. Dr V Flaherman, University of California, San Francisco, 3333 California St, Box 0503, San Francisco, CA 94143-0503, USA; FlahermanV{at}peds.ucsf.edu

Abstract

Background: A recent study proposed a risk factor scoring system for prediction of hyperbilirubinaemia that assigned increased risk to infants of higher birth weight.

Objective: To investigate this novel finding in a large, retrospective cohort analysis.

Methods: 105 384 newborns (⩾2000 g and ⩾36 weeks) were analysed, and the effect of higher birth weight on total serum bilirubin (TSB) ⩾342 μmol/l was reported using logistic regression to control for gestational age, scalp injury diagnosis, maternal diabetes, method of delivery and other confounders.

Results: The odds ratio for the effect of an additional 500 g of birth weight on TSB ⩾342 μmol/l declined with increasing gestational age from 1.55 (95% CI 1.28 to 1.87) at 36 weeks to 1.30 (95% CI 1.12 to 1.50) at 37 weeks and 1.14 (95% CI 1.01 to 1.29) at 38 weeks. There was no association for infants ⩾39 weeks.

Conclusion: Higher birth weight predicts TSB ⩾342 μmol/l in 36–38 week infants, but not in infants ⩾39 weeks. Further research should explore the causal mechanism for the association in less-mature infants.

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Footnotes

  • Competing interests: None.

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