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Neonatal Hyperbilirubinemia at High Altitude
Cynthia Leibson, PhD;
Mark Brown, MD;
Steve Thibodeau, PhD;
David Stevenson, MD;
Hendrik Vreman, PhD;
Ron Cohen, MD;
Gisela Clemons, PhD;
Wayne Callen, MD;
Lorna Grindlay Moore, PhD
Am J Dis Child. 1989;143(8):983-987.
Abstract
• A previous retrospective study showed an increased frequency of neonatal hyperbilirubinemia at high altitude in Colorado. In a prospective study we found that 39% of newborns at 3100m altitude vs 16% at 1600 m exhibited hyperbilirubinemia, defined as a day 3 serum bilirubin level of 205 µmol/L or higher. Increased bilirubin production at 3100 m vs 1600 m was shown by increased levels of corrected carboxyhemoglobin. This finding was supported by increased erythropoietin and bilirubin values in cord blood and increased hematocrit values at day 3 among infants at 3100 m vs 1600 m. The sustained elevation in bilirubin for breastfed vs formula-fed infants at 1600 m was observed for both feeding types at 3100 m. The findings suggested that there is a hematologic response to decreased oxygen availability at high altitude, resulting in increased bilirubin production accompanied by delayed bilirubin clearance.
(AJDC. 1989;143:983-987)
Author Affiliations
From the Department of Anthropology, University of Colorado at Denver (Drs Leibson and Moore); the Department of Pediatrics, University of Colorado Health Sciences Center, Denver (Dr Brown); Children's Hospital, Denver, Colo (Drs Brown and Thibodeau); Neonatology Metabolism Laboratory, Stanford University, Palo Alto, Calif (Drs Stevenson and Vreman); Santa Clara Valley Medical Center, San Jose, Calif (Dr Cohen); Lawrence Berkeley Laboratories, Berkeley, Calif (Dr Clemons); St Vincent Hospital, Leadville, Colo (Dr Callen); and Cardiovascular Pulmonary Research Laboratory, University of Colorado Health Sciences Center, Denver (Dr Moore).
Footnotes
Accepted for publication October 31, 1988.
Reprint requests to Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905 (Dr Leibson).
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