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Published Online First: 19 February 2008. doi:10.1136/adc.2007.130880
Archives of Disease in Childhood - Fetal and Neonatal Edition 2008;93:F307-F309
Copyright © 2008 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health.

SHORT REPORTS

Predicting significant hyperbilirubinaemia using birth weight

V J Flaherman1, A Ferrara2,3 and T B Newman1,2,4

1 Division of General Pediatrics, University of California, San Francisco, California, USA
2 Division of Research, Kaiser Permanente Medical Care Program, Oakland, California, USA
3 Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA
4 Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA

Correspondence to:
Dr V Flaherman, University of California, San Francisco, 3333 California St, Box 0503, San Francisco, CA 94143-0503, USA; FlahermanV{at}peds.ucsf.edu

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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