PEDIATRICS Vol. 90 No. 5 November 1992, pp. 741-743
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Risk of Sepsis in Newborns With Severe Hyperbilirubinemia

M. Jeffrey Maisels MB, BCh1 and Elizabeth Kring RN1

1 From the Division of Newborn Medicine, Department of Pediatrics, William Beaumont Hospital, Royal Oak, MI.

Because bacterial infection is a potential cause of hyperbilirubinemia, some authors suggest that newborns with significant unexplained indirect hyperbilirubinemia should be evaluated for sepsis. We reviewed the charts of 306 newborns admitted to a pediatric ward within 21 days of birth with a diagnosis of indirect hyperbilirubinemia (peak serum bilirubin level 316 ± 48, range 217 to 498 µmol/L) (18.5 ± 2.8, 12.7 to 29.1 mg/dL). Ninety percent were fully or partially breast-fed. Sepsis was identified in 0 of 306 newborns (upper 95% confidence limit for the risk of sepsis = 1%). The overwhelming majority of newborns who require readmission to hospital for indirect hyperbilirubinemia are healthy, breast-fed newborns and do not need to be investigated for sepsis. If indirect hyperbilirubinemia is ever the only manifestation of bacteremia or incipient sepsis, it must be a rare event.

Key Words: newborn • hyperbilirubinemia • breast-feeding • breast milk jaundice • sepsis

Submitted on April 10, 1992
Accepted on June 29, 1992




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