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. 2023 Nov 16;10(11):1819.
doi: 10.3390/children10111819.

Early-Term Neonates Demonstrate a Higher Likelihood of Requiring Phototherapy Compared to Those Born Full-Term

Teck-Jin Tan  1   2 , Wan-Ju Chen  2   3 , Wan-Chun Lin  4 , Ming-Chun Yang  1   2 , Ching-Chung Tsai  1   2 , Yung-Ning Yang  1   2 , San-Nan Yang  1   2 , Hsien-Kuan Liu  1   2
Affiliations

Early-Term Neonates Demonstrate a Higher Likelihood of Requiring Phototherapy Compared to Those Born Full-Term

Teck-Jin Tan et al. Children (Basel). .

Abstract

Early-term neonates (with a gestational age (GA) of 37 and 0/7 weeks to 38 and 6/7 weeks) face higher morbidities, including respiratory and neurodevelopmental issues, than full-term (39 and 0/7 weeks to 40 and 6/7 weeks) infants. This study explores whether hyperbilirubinemia necessitating phototherapy also differs between these groups. A retrospective study was conducted on neonates born from January 2021-June 2022, excluding those with specific conditions. Evaluated factors included GA, birth weight, bilirubin levels, glucose-6-phosphate dehydrogenase (G6PD) deficiency, and feeding type, with phototherapy given as per AAP guidelines. Of 1085 neonates, 356 met the criteria. When stratifying the neonates based on the need for phototherapy, a higher proportion of early-term neonates required phototherapy compared to full-term (p < 0.05). After factoring in various risks (GA; birth weight; gender; feeding type; G6PD deficiency; transcutaneous bilirubin levels at 24 h and 24-48 h postpartum; maternal diabetes; and the presence of caput succedaneum or cephalohematoma), early-term neonates were more likely to need phototherapy than full-term babies (OR: 2.15, 95% CI: 1.21 to 3.80). The optimal cut-off for transcutaneous bilirubin levels 24-48 h postpartum that were used to predict phototherapy need was 9.85 mg/dl. In conclusion, early-term neonates are at a greater risk for developing jaundice and requiring phototherapy than full-term neonates. Monitoring bilirubin 24-48 h postpartum enhances early prediction and intervention.

Keywords: early term; full term; hyperbilirubinemia; phototherapy; transcutaneous bilirubin.

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Conflict of interest statement

The authors declare no conflict of interest. The funding sources were not involved in the study’s design, data collection, analysis, or interpretation; the composition of the manuscript; or the decision to submit the results for publication.

Figures

Figure 1
Figure 1
Neonate selection process from an initial cohort of 1085, following exclusion criteria application. a Encompasses transient tachypnea of the newborn, neonatal pneumonia/pneumonitis, and meconium aspiration syndrome; b encompasses fever episodes, bacteremia, and meningitis; c encompasses congenital anomalies of the heart, gastrointestinal tract, biliary tract, and additional genetic diseases.
Figure 2
Figure 2
ROC curves of TcB levels measured between 24 and 48 h postpartum to predict the requirement for phototherapy.
See this image and copyright information in PMC

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