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Extreme neonatal hyperbilirubinemia and kernicterus spectrum disorder in Denmark during the years 2000–2015



To determine the incidence and etiology of extreme neonatal hyperbilirubinemia, defined as total serum bilirubin (TSB) ≥450 µmol/L, and kernicterus spectrum disorder (KSD) in Denmark between 2000 and 2015.

Study design

We identified all infants born between 01.01.2000 and 31.12.2015 with TSB ≥450 µmol/L, ratio of conjugated to TSB <0.30, gestational age ≥35 weeks, and postnatal age ≤4 weeks, using Danish hospitals’ laboratory databases.


We included 408 infants. The incidence of extreme neonatal hyperbilirubinemia among infants with gestational age ≥35 weeks was 42/100,000 during the study period with a seemingly decreasing incidence between 2005 and 2015. Twelve of the 408 infants developed KSD, (incidence 1.2/100,000) Blood type ABO isohemolytic disease was the most common explanatory etiology.


Our study stresses the importance of a systematic approach to neonatal jaundice and ongoing surveillance of extreme neonatal hyperbilirubinemia and KSD.

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We would like to thank all biochemical, pediatric, radiological, and audiological departments throughout Denmark for their great help in collecting the material.

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Correspondence to Mette Line Donneborg.

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The authors declare that they have no conflict of interest.


The study was approved by the Danish Data Protection Agency, 2008-58-0028/ 2016-71, and the Danish Health Authority, 3-3013-1624/1.

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Donneborg, M.L., Hansen, B.M., Vandborg, P.K. et al. Extreme neonatal hyperbilirubinemia and kernicterus spectrum disorder in Denmark during the years 2000–2015. J Perinatol 40, 194–202 (2020).

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