FREQUENCY AND RISK FACTORS OF REBOUND HYPERBILIRUBINEMIA IN NEONATES FOLLOWING PHOTOTHERAPY: A CROSS-SECTIONAL STUDY

Original Article

Abstract

Background: Neonatal hyperbilirubinemia is a common condition often treated with phototherapy. However, some neonates develop rebound hyperbilirubinemia after cessation of treatment, leading to possible retreatment and longer hospital stays.

Objective: To determine the frequency of rebound hyperbilirubinemia in neonates following phototherapy and to identify the associated risk factors.

Study Design: A cross-sectional study.

Place and Duration of Study: Pediatric Department, Women and Children Hospital Abbottabad, from February 2024 to January 2025.

Methodology: A total of 154 neonates (aged ≤7 days) with jaundice who received phototherapy were included. Serum bilirubin levels were measured before and 24 ± 6 hours after discontinuation of phototherapy. Risk factors were assessed through blood smear, reticulocyte count, direct Coombs test, G6PD levels, and blood grouping of both mother and neonate. Data were collected using a structured proforma and analyzed using SPSS version 20.

Results: Out of 154 neonates, 92 (59.7%) were males and 62 (40.3%) were females, with a mean age of 59.24 ± 13.99 hours. The mean gestational age was 37.17 ± 2.7 weeks. A total of 34 (22.1%) neonates developed significant rebound hyperbilirubinemia. Gestational age less than 35 weeks, birth weight <2000 g, and hemolytic disease were identified as significant risk factors (p-value <0.05).

Conclusion: Rebound hyperbilirubinemia may occur after phototherapy, particularly in neonates with prematurity, low birth weight, and hemolytic disease. These risk factors should be considered in post-phototherapy monitoring and follow-up.