Clinical and Laboratory Profile of Hyperbilirubinemia in Infants Up to Nine Weeks of Age: A Retrospective Study from Oradea, Romania

Background: Hyperbilirubinemia is one of the most common clinical problems encountered during the neonatal and early-infant period. Although it is frequently benign, significant bilirubin elevation may lead to acute bilirubin encephalopathy and kernicterus, and its clinical interpretation depends on postnatal age, gestational maturity, feeding, hemolysis, and other risk factors. However, hospital-based data describing the demographic, perinatal, clinical, laboratory, and hospitalization characteristics of affected young infants remain limited in some settings. This study aimed to describe these characteristics among infants with hyperbilirubinemia admitted to a pediatric hospital in Oradea, Romania. Material and Methods: The records of 30 infants up to 9 weeks of age who were admitted to the hospital between July 2020 and December 2021 were retrospectively reviewed. Variables were age, sex, parity, birth order, weight, method of birth, APGAR score, maternal age, place of residence, gestation period, feeding pattern, signs/symptoms at delivery, abnormal laboratory findings which were selected, and length of hospital stay. Because the available data were in aggregated form, descriptive analysis was undertaken. 95% Wilson confidence intervals were used to report proportions with known denominators. Results: 17 of 30 (56.7%) infants were boys, 25 of 30 (83.3%) had physiologic pregnancies and 19 were from rural locations. Twenty-three (76.7%) were term, 18 (60.0%) were exclusively breastfed, and 18 (60.0%) had a birth weight of 3–4 kg. Infants aged 3–4 weeks formed the largest age group (14/30, 46.7%). Of 24 babies with actually known scores, 20 (83.3%) obtained a score of 9. The most common isolated presentation was vomiting (5 cases, 16.7%). Twenty-three infants (76.7%) had elevated indirect bilirubin, 12 (40.0%) had elevated gamma-glutamyl transferase. The average length of stay in the hospital was about 7 days based on source data. Conclusion: This small hospital-based series included a predominant number of infants with a term delivery, normal birth weight, and breastfed infants; the most common laboratory abnormality was elevation of indirect bilirubin. The results are descriptive and hypothesis-generating and should not be interpreted as estimates of population risk or evidence of causal associations.

Keywords: Hyperbilirubinemia; neonatal jaundice; bilirubin; infants; breastfeeding.