Risk factors and construction of a risk prediction model for readmission due to hyperbilirubinemia in neonates with ABO hemolytic disease of the newborn

Pei-Xian YUE, Hong-Ling CAO, Rong LI

Chinese Journal of Contemporary Pediatrics ›› 2025, Vol. 27 ›› Issue (7) : 834-841.

PDF(916 KB)
PDF(916 KB)
Chinese Journal of Contemporary Pediatrics ›› 2025, Vol. 27 ›› Issue (7) : 834-841. DOI: 10.7499/j.issn.1008-8830.2412037
CLINICAL RESEARCH

Risk factors and construction of a risk prediction model for readmission due to hyperbilirubinemia in neonates with ABO hemolytic disease of the newborn

Author information +
History +

Abstract

Objective To investigate the readmission rate and risk factors for readmission due to hyperbilirubinemia in neonates with ABO hemolytic disease of the newborn (ABO-HDN), and to construct a risk prediction model for readmission. Methods Neonates diagnosed with hyperbilirubinemia due to ABO-HDN and hospitalized in the neonatal department between January 2021 and December 2023 were enrolled. Based on readmission status, neonates were divided into a readmission group and a control group. Clinical characteristics related to hyperbilirubinemia and risk factors for readmission were analyzed. Subsequently, a prediction model for readmission was constructed, and its predictive performance was evaluated. Results A total of 483 neonates with hyperbilirubinemia due to ABO-HDN were included. The readmission rate was 13.0% (63 cases). Multivariate logistic regression analysis revealed that earlier age at phototherapy initiation, longer duration of phototherapy, occurrence of rebound hyperbilirubinemia, and higher levels of serum total bilirubin and indirect bilirubin at discharge were independent risk factors for hyperbilirubinemia readmission in ABO-HDN neonates (OR=2.373, 4.840, 6.475, 5.033, 1.336 respectively; P<0.05). A risk prediction model for ABO-HDN hyperbilirubinemia readmission was constructed based on these 5 risk factors. Model evaluation demonstrated good predictive performance. Conclusions Age at phototherapy initiation, duration of phototherapy, occurrence of rebound hyperbilirubinemia, and serum total bilirubin and indirect bilirubin levels at discharge are significant influencing factors for readmission due to hyperbilirubinemia in neonates with ABO-HDN. Close monitoring during discharge planning and follow-up management for such neonates is crucial to reduce readmission rates.

Key words

ABO hemolytic disease / Hyperbilirubinemia / Readmission / Risk factor / Neonate

Cite this article

Download Citations
Pei-Xian YUE , Hong-Ling CAO , Rong LI. Risk factors and construction of a risk prediction model for readmission due to hyperbilirubinemia in neonates with ABO hemolytic disease of the newborn[J]. Chinese Journal of Contemporary Pediatrics. 2025, 27(7): 834-841 https://doi.org/10.7499/j.issn.1008-8830.2412037

References

[1]
Battersby C, Michaelides S, Upton M, et al. Term admissions to neonatal units in England: a role for transitional care? A retrospective cohort study[J]. BMJ Open, 2017, 7(5): e016050. PMCID: PMC5726072. DOI: 10.1136/bmjopen-2017-016050 .
[2]
Watchko JF. Identification of neonates at risk for hazardous hyperbilirubinemia: emerging clinical insights[J]. Pediatr Clin North Am, 2009, 56(3): 671-687. DOI: 10.1016/j.pcl.2009.04.005 .
[3]
Ma XL, Chen Z, Zhu JJ, et al. Management strategies of neonatal jaundice during the coronavirus disease 2019 outbreak[J]. World J Pediatr, 2020, 16(3): 247-250. PMCID: PMC7090695. DOI: 10.1007/s12519-020-00347-3 .
[4]
Manzar S. Severity of hyperbilirubinaemia[J]. J Paediatr Child Health, 2022, 58(9): 1704. DOI: 10.1111/jpc.16123 .
[5]
Anne RP, Rahiman EA. Prediction of neonatal hyperbilirubinemia using 1st day serum bilirubin levels: correspondence[J]. Indian J Pediatr, 2019, 86(12): 1166. DOI: 10.1007/s12098-019-03018-y .
[6]
Pan J, Zhan C, Yuan T, et al. Intravenous immunoglobulin G in the treatment of ABO hemolytic disease of the newborn during the early neonatal period at a tertiary academic hospital: a retrospective study[J]. J Perinatol, 2021, 41(6): 1397-1402. PMCID: PMC8225508. DOI: 10.1038/s41372-021-00963-5 .
[7]
Hassanzadeh-Nazarabadi M, Shekouhi S, Seif N. The incidence of spontaneous abortion in mothers with blood group O compared with other blood types[J]. Int J Mol Cell Med, 2012, 1(2): 99-104. PMCID: PMC3920496.
[8]
Daunhawer I, Kasser S, Koch G, et al. Enhanced early prediction of clinically relevant neonatal hyperbilirubinemia with machine learning[J]. Pediatr Res, 2019, 86(1): 122-127. DOI: 10.1038/s41390-019-0384-x .
[9]
Khurana R, Batra P, Faridi M, et al. Revisiting ABO incompatibility as a risk factor for significant neonatal hyperbilirubinemia[J]. Trop Doct, 2019, 49(3): 201-204. DOI: 10.1177/0049475519838428 .
[10]
中华医学会儿科学分会新生儿学组, 《中华儿科杂志》编辑委员会. 新生儿高胆红素血症诊断和治疗专家共识[J]. 中华儿科杂志, 2014, 52(10): 745-748. DOI: 10.3760/cma.j.issn.0578-1310.2014.10.006 .
[11]
杨璇, 陈富臻, 洪强. 501例新生儿溶血病筛查结果分析[J]. 中国实验血液学杂志, 2019, 27(1): 192-196. DOI: 10.7534/j.issn.1009-2137.2019.01.031 .
[12]
van der Geest BAM, de Mol MJS, Barendse ISA, et al. Assessment, management, and incidence of neonatal jaundice in healthy neonates cared for in primary care: a prospective cohort study[J]. Sci Rep, 2022, 12(1): 14385. PMCID: PMC9399078. DOI: 10.1038/s41598-022-17933-2 .
[13]
申子瑜. 我国临床实验室质量管理的基本要求[J]. 中华检验医学杂志, 2003, 26(11): 700-701. DOI: 10.3760/j:issn:1009-9158.2003.11.022 .
[14]
黄德恩, 黄剑飞, 林扬熹, 等. 新生儿高胆红素血症治疗进展的分析[J]. 中国现代药物应用, 2013, 7(14): 239-241. DOI: 10.3969/j.issn.1673-9523.2013.14.203 .
[15]
高璐, 芦起. 新生儿光疗不良反应研究进展[J]. 中华新生儿科杂志, 2021, 36(2): 75-78. DOI: 10.3760/cma.j.issn.2096-2932.2021.02.018 .
[16]
Bhutani VK, Johnson L, Sivieri EM. Predictive ability of a predischarge hour-specific serum bilirubin for subsequent significant hyperbilirubinemia in healthy term and near-term newborns[J]. Pediatrics, 1999, 103(1): 6-14. DOI: 10.1542/peds.103.1.6 .
[17]
Chang PW, Newman TB. A simpler prediction rule for rebound hyperbilirubinemia[J]. Pediatrics, 2019, 144(1): e20183712. DOI: 10.1542/peds.2018-3712 .
[18]
杨静丽, 王建辉. 2022版 美国儿科学会新生儿高胆红素血症管理指南解读[J]. 中国当代儿科杂志, 2023, 25(1): 11-17. PMCID: PMC9893820. DOI: 10.7499/j.issn.1008-8830.2210119 .
[19]
Routray SS, Behera R, Mallick B, et al. The spectrum of hemolytic disease of the newborn: evaluating the etiology of unconjugated hyperbilirubinemia among neonates pertinent to immunohematological workup[J]. Cureus, 2021, 13(8): e16940. PMCID: PMC8418802. DOI: 10.7759/cureus.16940 .
[20]
Woodgate P, Jardine LA. Neonatal jaundice[J]. BMJ Clin Evid, 2011, 2011: 0319. PMCID: PMC3217664.
[21]
Elhawary IM, Abdel Ghany EAG, Aboelhamed WA, et al. Incidence and risk factors of post-phototherapy neonatal rebound hyperbilirubinemia[J]. World J Pediatr, 2018, 14(4): 350-356. DOI: 10.1007/s12519-018-0119-9 .
[22]
Tsujimae S, Yoshii K, Yamana K, et al. Hyperbilirubinemia in term newborns needing phototherapy within 48 hours after birth in a Japanese birth center[J]. Kobe J Med Sci, 2018, 64(1): E20-E25. PMCID: PMC6192821.
[23]
Barak M, Berger I, Dollberg S, et al. When should phototherapy be stopped? A pilot study comparing two targets of serum bilirubin concentration[J]. Acta Paediatr, 2009, 98(2): 277-281. DOI: 10.1111/j.1651-2227.2008.01015.x .
[24]
Keir A, Agpalo M, Lieberman L, et al. How to use: the direct antiglobulin test in newborns[J]. Arch Dis Child Educ Pract Ed, 2015, 100(4): 198-203. DOI: 10.1136/archdischild-2013-305553 .
[25]
Xu C, Bao Y, He Y, et al. Risk factors for readmission for hyperbilirubinemia in neonates with ABO hemolytic disease: a single-center retrospective cohort study[J]. J Matern Fetal Neonatal Med, 2023, 36(2): 2238106. DOI: 10.1080/14767058.2023.2238106 .

Footnotes

所有作者均声明无利益冲突。

PDF(916 KB)

Accesses

Citation

Detail

Sections
Recommended

/