The Comparison of Pro-Oxidant-Antioxidant Balance in Physiologic and Pathologic Jaundice

Background: Jaundice can be observed in two-thirds of infants. Bilirubin prevents damage to the DNA from the oxidative stress of reactive oxygen species (ROS). Moreover, bilirubin has anti-inflammatory and anti-apoptotic roles in addition to antioxidant properties. Objectives: We decided to compare pro-oxidant-antioxidant balance (PAB) in physiologic and pathologic jaundice. Methods: This cross-sectional study evaluated 171 infants more than 35 weeks of gestational and > 2 days of postnatal age who were admitted to the Ghaem Hospital with jaundice from 2017 to 2019. Infants with bilirubin levels less or equal to 14 mg/dL on the jaundice meter were put in the physiologic jaundice group and infants with bilirubin higher than 15 mg/dL on the jaundice meter were entered into the study as the pathologic jaundice group. A questionnaire containing data regarding neonate’s characteristics and the mother’s medical history was filled out for each infant. Bilirubin levels, hematocrit, direct and or indirect Combs, reticulocytes, and PAB were evaluated in the case group. Results: The average age of the enrolled neonates was 7.3 ± 4.11 days and 52.4% of them were male. Between two groups of physiologic and pathologic jaundice, gestational age (P = 0.010), parity (P = 0.001) and PAB (P = 0.000) were significantly different. Overall, the amounts of the mentioned parameters in the pathologic jaundice group were less than the physiologic jaundice group. Conclusions: A pathological increase in bilirubin levels irrespective of its neurotoxic properties can change the pro-oxidant-antioxidant balance in favor of antioxidants. It seems that neurotoxic mechanism of bilirubin in pathological amounts differ with its antioxidant effects.