Comparison of Bilirubin Levels in Neonates with Hyperbilirubinemia according to Delivery Methods

Objective: This study aimed to find out the correlation between bilirubin levels and delivery methods in term babies with neonatal hyperbilirubinemia. Methods: This retrospective study was performed in a single center. The subjects were full-term neonates (37-41 weeks of gestational age) with a chief complaint of hyperbilirubinemia (serum total bilirubin ≥12 mg/dL) admitted to the Bundang Jesaeng General Hospital from May 2015 to July 2018. The subjects were divided into two groups according to delivery methods (vaginal delivery [VD] and cesarean section [CS]). Total bilirubin levels were compared between the two groups, and the correlation between severe hyperbilirubinemia (serum total bilirubin ≥25 mg/dL) and delivery methods was analyzed. Results: A total of 87 neonates were enrolled. Of 87 neonates, 59 (67.8%) were born by VD and 28 (32.2%) by CS. The mean serum total bilirubin level of the VD group was significantly higher than that of the CS group (21.5±4.0 mg/dL and 17.5±3.4 mg/dL, respectively; P<0.001). There were also significant differences in bilirubin levels according to delivery methods in subgroups based on demographic characteristics, except in cases when the age of neonates exceeded 7 days on admission and in breast-feeding neonates. In addition, VD was significantly correlated with an increased risk of severe hyperbilirubinemia (relative risk 1.5; 95% confidence interval 1.2-1.9; P=0.031). Conclusion: This study showed that term neonates with hyperbilirubinemia born by VD had significantly higher bilirubin levels than those born by CS, and were also significantly correlated with severe hyperbilirubinemia.