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Abstract
Despite hyperbilirubinemia being a common morbidity among neonates, few studies have systematically studied the phenomenon of post{u2010}phototherapy rebound, data about the phenomenon of bilirubin rebound is lacking. The aim of this study is to determine the incidence and risk factors of post phototherapy neonatal rebound hyperbilirubinemia and the prevalence of each risk factor. A prospective cohort study was performed on 500 neonates with indirect hyperbilirubinemia treated with phototherapy as primary or secondry line. Neonates were tested for total seurm bilirubin at ( 24 - 36) hours after discontinuation of phototherapy, with additional testing as clinically indicated. A total of 124 (24.9%) neonates developed significant rebound hyperbilirubinemia, Multiple logistic regression analysis was done for significant risk factors of bilirubin rebound and it revealed the following important risks: sepsis (OR: 7.01 and 95%CI (3.08 - 15.93), P value < 0.001), exposure to intensive phototherapy (OR: 2.62 and 95%CI (1.2 7- 5.40), P value = 0.009), hemolytic causes(OR: 2.58 and 95% CI (1.53 - 4.38), P value < 0.001) , higher discharge bilirubin level (OR: 1.35 and 95%CI (1.15 - 1.57), P value < 0.001), low birth weight(OR:0.35 and 95% CI (0.21 - 0.58), P value < 0.001), and shorter duration of conventional phototherapy (OR:0.33 and 95%CI (0.24 - 0.45), P value < 0.001), and also rapid rate of decline of bilirubin in 1st 8 hours (P value = 0.03) and early onset of jaundice (P value = 0.3) were considered as important risk factors