Objective:To perform risk factor analysis for the prediction of hyperbilirubinemia in an African American male neonatal cohort. Study design:A database of 500 previously published term and near-term African American male neonates was further analyzed to determine the role of risk factors for hyperbilirubinemia. Factors studied included birth weight ≥4.0kg,gestational age ≤37 weeks,breast-feeding,glucose-6-phosphate dehydrogenase (G-6-PD) deficiency,and predischarge bilirubin ≥75th percentile. Hyperbilirubinemia was defined as any bilirubin value ≥95th percentile on the hour-of-life-specificbilir-ubin nomogram. Results:Forty-three (8.6%) neonates developed hyperbilirubinemia. At 48 ±12 hours,median transcutaneous bilirubin was 8.3 mg/dL,75th percentile 10.0mg/dL,and 95th percentile 12.6 mg/dL. Of the risk factors,only exclusive breast-feeding,G-6-PD deficiency and predischarge bilirubin ≥75th percentile were significant (Adjusted Odds Ratios 95%Confidence Intervals; CI 3.15 1.39-7.14 ,P = 0.006; 4.96 2.28-10.80 ,P = 0.001; and 7.47 3.50-15.94 ,P < 0.0001,respectively). G-6-PD-deficient neonates who were also premature and breast-feeding had the highest incidence of hyperbilirubinemia (60%). Conclusions:African American male neonates may be at higher risk for hyperbilirubinemia than previously thought. Screening for G-6-PD deficiency and predischarge bilirubin determination may be useful adjuncts in hyperbilirubinemia prediction in these newborns.
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