Serial Evaluation of Serum Direct Bilirubin Values in Very Low Birth Weight Infants during NICU admission

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  • 極低出生体重児（VLBWI）における直接ビリルビン値の検討

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<p> This study aimed to investigate the trends of direct bilirubin（DB）values in very low birth weight infants（VLBWI）and identify perinatal factors associated with the development of direct hyperbilirubinemia（peak DB ≥ 2.0 mg/dL）.</p><p> The study enrolled 206 VLBWI（29.4 weeks, 1, 066 g）born and managed in our NICU between January 2017 and May 2021. We routinely measured serum direct bilirubin（SDB）value in each patient every two weeks, starting from day 14, and determined the chronological and postconceptional age at which peak SDB was achieved. Additionally, we investigated perinatal factors contributing to the development of direct hyperbilirubinemia.</p><p> The mean chronological age of peak SDB was 42±27 days, displaying multimodal distribution characteristics. In contrast, the mean postconceptional age of peak SDB was at 35.3±4.0 weeks with unimodal distribution. Further, logistic regression analysis revealed that birth weight z score（p=0.001; odds ratio［OR］0.345）and age at full enteral nutrition establishment（feeding volume ≥100 ml/kg/day; p=0.012; OR 1.663）were significant perinatal factors influencing direct hyperbilirubinemia.</p><p> Our findings indicated that the excretion of DB was influenced by the term period, and a higher degree of fetal growth retardation and delayed attainment of enteral nutrition may be risk factors for subsequent direct hyperbilirubinemia in VLBWIs.</p>

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