Relation between serum bilirubin levels greater than or equal to 450 mu mol/L and bilirubin encephalopathy; a Danish population-based study

• Published in: Acta Paediatrica Vol. 101; no. 4; pp. 384 - 389
• Main Authors: Ebbesen, Finn, Bjerre, Jesper V, Vandborg, Pernille K
• Format: Journal Article
• Language: English
• Published: 01-04-2012
• Subjects: Bilirubin; Complications; Encephalopathy; Gestational age; Infants; Information systems; Population studies
• ISSN: 0803-5253; 1651-2227
• DOI: 10.1111/j.1651-2227.2011.02565.x

Aim: Describe the relation between levels of total serum bilirubin (TsB) greater than or equal to 450 mu mol/L and acute intermediate, acute advanced and chronic bilirubin encephalopathy. Material and methods: All infants born at gestational age greater than or equal to 35weeks in Denmark between 2000 and 2007 with a TsB greater than or equal to 450 mu mol/L according to the national laboratory information system. Infants diagnosed with bilirubin encephalopathy were found in the Danish National Registry of Patients. Results: 502766 infants at gestational age greater than or equal to 35weeks were identified. Two hundred twenty-four developed a TsB greater than or equal to 450 mu mol/L, equivalent to an incidence of 45/100000/year, and it increased during the period. Incidence of infants with peak TsB of 450-499, 500-599 and 600-1000 mu mol/L were 29.6, 12.7 and 2.2 per 100000, respectively. Three infants had acute advanced bilirubin encephalopathy and got severe sequelae, whereas the two infants with acute intermediate encephalopathy developed normally. Their peak TsB was greater than or equal to 544 mu mol/L. Having a peak TsB 600-1000 mu mol/L, the risk of acute advanced and chronic bilirubin encephalopathy was 27% (95% CI 6; 61), and the incidence of these conditions was 0.6 (95% CI 0.1; 1.7) per 100000. Conclusion: The incidence of infants with TsB greater than or equal to 450 mu mol/L was 45/100000/year. Infants with a TsB greater than or equal to 600 mu mol/L had a substantial risk of developing acute advanced and chronic bilirubin encephalopathy, and the incidence of these conditions was 0.6 per 100000.