Objective: Bilirubin encephalopathy continued to be reported worldwide. This multicenter study was conducted to explore the clinical characteristics, comorbidities and prognosis of bilirubin encephalopathy in China.
Methods: The survey was conducted in 33 level III hospitals. Clinical charts of infants with diagnosis of bilirubin encephalopathy or kernicterus at discharge were reviewed. The data were collected by a detaild questionnaire and analyzed.
Results: From January to December in 2009, 348 cases of bilirubin encephalopathy were reported from 28 hospitals. The mean birth weight was (3112.4 ± 599.6) grams, mean gestational age was (38.3 ± 2.3) weeks; 291 (83.6%) cases were term infants, 40 (11.5%) cases were late-preterm infants, and 11 (3.2%) cases were early preterm infants. After admission, the highest bilirubin level was (478.1 ± 175.8) µmol/L. Of all the 348 cases, the age at admission was (7.3 ± 5.4) days; 247 (71.0%) cases were admitted before 7 days of age, 24 (6.9%) cases were admitted after 14 days of age. Most of the cases (86.2%) were complicated with other conditions, including bacterial infection (52.6%), ABO incompatibility (29.9%), and perinatal asphyxia (10.1%). A total of 131 infants (37.6%) underwent an exchange transfusion. Use of albumin, intravenous immunoglobulin was also common (68.7% and 44.0% respectively). A total of 52 cases were of minority ethnic groups, with significantly higher rate of G6PD deficiency than Han ethnicity cases. During the hospitalization and follow up, 36 infants died, and 125 infants (35.9%) were lost to follow up.
Conclusions: Bilirubin encephalopathy is still not rare in China, the establishment of a population-based reporting system and prevention of kernicterus remain a high priority among public health institutions.