Prevalence and risk factors for hyperbilirubinemia among newborns from a low‐risk birth setting using delayed cord clamping in Japan

Abstract

AimNeonatal jaundice is a common problem among infants. Among the several risk factors are East Asian race and delayed cord clamping. Birth centers manage low‐risk term deliveries using physiological management, which may include delayed cord clamping. This study aimed to investigate the occurrence of hyperbilirubinemia, a pathological process of jaundice, and its risk factors among neonates born at a Japanese birth center.MethodsThis was a retrospective cohort study. Data were collected from March 2006 to October 2014 from healthy mothers and neonates at a birth center in a metropolitan area of Japan. Demographic data and background factors of hyperbilirubinemia, including blood and transcutaneous values of jaundice, were collected and statistically analyzed.ResultsOf the 1,211 neonates analyzed, 4.7% exceeded the standard transcutaneous bilirubin value, and 1.8% needed phototherapy. Multiple logistic regression with adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) was used to identify the risk factors of hyperbilirubinemia, which were found to be cephalohematoma (OR = 30.18, 95% CI 5.63–161.69), delay of meconium elimination (OR = 2.66, 95% CI 1.28–5.51), previous history of phototherapy of siblings (OR = 10.28, 95% CI 3.53–29.92), and primiparity (OR = 4.55, 95% CI 2.59–8.02).ConclusionsIn low‐risk Japanese neonates delivered at a birth center expected to practice delayed cord clamping, the rate of neonates requiring phototherapy was not high compared to previous studies, and the identified risk factors of hyperbilirubinemia were related to bilirubin metabolism.

Differential Effects of Later Cord Clamping on Bilirubin Levels in Normal and Diabetic Pregnancies

“…Although the incidence of jaundice requiring phototherapy in term infants after later cord clamping is slightly increased [14], most studies [22,23] and our study have con rmed that there were no signi cant difference in bilirubin levels and phototherapy rates in neonates of mothers without pregnancy complications between ICC group and LCC group. However, in diabetic pregnant woman, LCC was able to signi cantly increase neonatal bilirubin levels and phototherapy rates compared to ICC.…”

Effects of timing of umbilical cord clamping on preventing early infancy anemia in low-risk Japanese term infants with planned breastfeeding: a randomized controlled trial

“…In Japan, approximately 90% of clinics or hospitals have adopted a policy of ECC, conversely nearly 70% of midwifery birth centers have adopted a policy of DCC [13]. A retrospective cohort survey reported that only 1.8% of neonates required phototherapy at a birth center where DCC was conducted [14]. In addition, a recent observational study reported no significant association between the timing of umbilical cord clamping, infant anemia at 3 to 5 months, and neonatal jaundice [15].…”

Effects of Timing of Umbilical Cord Clamping on Preventing Early Infancy Anemia in Japanese Term Infants With Planned Breastfeeding: A Randomized Controlled Trial

“…In Japan, approximately 90% of clinics or hospitals have adopted a policy of ECC, conversely nearly 70% of midwifery birth centers have adopted the policy of DCC [13]. A retrospective cohort survey reported that only 1.8% of the neonates required phototherapy at a birth center where DCC was conducted [14]. In addition, a recent observational study reported no signi cant association between the timing of umbilical cord clamping, infant anemia at 3 to 5 months, and neonatal jaundice [15].…”