Comparison of Total Bilirubin in Small for Gestational Age (SGA) and Appropriate for Gestational Age (AGA) Infants between 48 Hours - 72 Hours

Edwin Dias ^1,2*, Shreyas TS Phayde ² and Pothireddy Sai Priya³

¹HOD and Professor, Department of Paediatrics, Srinivas Institute of Medical Sciences and Research Centre, Mangalore, Karnataka, India
²Adjunct Professor, Srinivas University, Director of Research and Publication, India
³Final Year Pharm D, Srinivas College of Pharmacy, Valachil, Mangalore, Karnataka, India

*Corresponding Author: Edwin Dias, HOD and Professor, Department of Paediatrics, Srinivas Institute of Medical Sciences and Research Centre, Mangalore, Karnataka, India.

Received: September 29, 2025; Published: October 20, 2025

Abstract

Introduction: Neonatal jaundice is a common clinical condition, particularly prevalent among infants with intrauterine growth restriction. Small for gestational age (SGA) infants are at increased risk for hyperbilirubinemia compared to their appropriate for gestational age (AGA) counterparts. Elevated total serum bilirubin levels in SGA infants may be attributed to factors such as delayed hepatic maturation and increased hemolysis. This study aims to compare total bilirubin levels between SGA and AGA infants at 48 hours post-birth, with additional analysis across subgroups on birth weight, feeding methods, maternal diabetes status, and phototherapy treatment intervention.

Objectives: To compare the mean total serum bilirubin levels between SGA and AGA infants at 48 hours post-birth. To analyze differences in bilirubin levels within the SGA and AGA subgroups based on the following subgroups: birth weight (low vs. normal), feeding method (breastfed vs. formula-fed), maternal diabetes status (infants of diabetic mothers (IDMs) vs. non-diabetic mothers), and phototherapy treatment (infants who received phototherapy vs. those who did not).

Materials and Methods: This observational study included a total 128 neonates, comprising 64 SGA and 64 AGA infants. Total serum bilirubin levels were measured 48 hours after birth using a direct measurement method. Subgroup analyses were conducted within both the SGA and AGA groups based on the following variables: birth weight (low vs. normal), feeding method (breastfed vs. formula-fed), maternal diabetes status (infants of diabetic mothers vs. non-diabetic mothers), and phototherapy treatment (with vs. without phototherapy). Statistical analyses were performed using independent t-tests and one-way analysis of variance (ANOVA), with a significance threshold set at p < 0.05.

Results: The mean total bilirubin level was significantly higher in SGA infants (12.5 mg/dL) than in AGA infants (8.7 mg/dL) (p < 0.001). Within the SGA group, LBW infants had higher bilirubin levels (13.8 mg/dL) compared to NBW infants (11.2 mg/dL) (p < 0.01). SGA formula-fed infants exhibited higher bilirubin levels (13.2 mg/dL) than breastfed SGA infants (11.8 mg/dL) (p < 0.05). Additionally, SGA infants born to diabetic mothers had higher bilirubin levels (13.5 mg/dL) than non-diabetic mothers (11.5 mg/dL) (p < 0.01). Phototherapy significantly reduced bilirubin levels in both SGA and AGA infants, with SGA infants receiving phototherapy showing a mean bilirubin level of 10.5 mg/dL versus 13.5 mg/dL in those who did not receive phototherapy (p < 0.001).

Conclusion: SGA infants exhibit significantly higher total bilirubin levels compared to AGA infants, with pronounced differences observed in specific subgroups. LBW SGA infants, formula-fed SGA infants, and SGA infants, and those born to diabetic mothers are particularly at risk for elevated bilirubin levels. Phototherapy is an effective intervention for reducing bilirubin levels in these infants. These findings underscore the importance of targeted bilirubin monitoring and management strategies for SGA infants to prevent complications associated with neonatal jaundice.

Keywords: Neonatal Jaundice; Small for Gestational Age (SGA); Appropriate for Gestational Age (AGA); Total Bilirubin Levels; Intrauterine Growth Restriction; Phototherapy; Birthweight; Feeding Methods; Maternal Diabetes; Hyperbilirubinemia

References

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Citation

Citation: Edwin Dias., et al. “Comparison of Total Bilirubin in Small for Gestational Age (SGA) and Appropriate for Gestational Age (AGA) Infants between 48 Hours - 72 Hours". Acta Scientific Paediatrics 8.11 (2025): 20-26.

Copyright

Copyright: © 2025 Edwin Dias., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.