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J Pediatr. 2011 Apr;158(4):562-565.e1. doi: 10.1016/j.jpeds.2010.09.061. Epub 2010 Nov 12.

Interpreting conjugated bilirubin levels in newborns.

Author information

1
Department of Pediatrics, California Pacific Medical Center, San Francisco, CA, USA. arahnd@gmail.com

Abstract

OBJECTIVE:

To examine the clinical significance of elevated conjugated bilirubin (CB) levels in newborns.

STUDY DESIGN:

This retrospective study evaluated a birth cohort of 271 186 full-term newborns born within a Northern California hospital network from 1995 to 2004. All CB and direct bilirubin (DB) levels were available in a database and were correlated with the patients' inpatient and outpatient International Classification of Diseases, 9th Revision diagnoses.

RESULTS:

The 99th percentile for CB is 0.5 mg/dL, and the 99th percentile for DB is 2.1 mg/dL. CB levels between 0.5 and 1.9 mg/dL can be associated with infection, but most often remain unexplained. Liver and biliary disease become increasingly likely as CB levels increase; for CB ≥5 mg/dL, 47% of newborns have biliary disease and 43% have liver disease.

CONCLUSIONS:

CB and DB levels are not interchangeable. In newborns with CB levels ≥0.5 mg/dL and <2 mg/dL, infection must be ruled out, and the newborn should be observed. In newborns with levels ≥2 mg/dL, a more in-depth assessment of the hepatobiliary system is indicated.

PMID:
21074172
PMCID:
PMC3058149
DOI:
10.1016/j.jpeds.2010.09.061
[Indexed for MEDLINE]
Free PMC Article

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