An Evaluation of Ursodeoxycholic Acid Treatment in Prolonged Unconjugated Hyperbilirubinemia due to Breast Milk

Abstract

Background/Aim: Prolonged jaundice is one of the most common problems during neonatal period. The aim of this study was to  evaluate the efficiency of ursodeoxycholic acid (UDCA) treatment in newborn infants with prolonged unconjugated hyperbilirubinemia. 

Materials and Methods: The present study included 27 patients who were fed by breast milk and followed up in the outpatient clinic due  to prolonged jaundice without any underlying etiological factor; 10 mg/kg/day UDCA was administrated in two doses for 7 days.  Furthermore, 20 newborns diagnosed with prolonged jaundice with same characteristics were enrolled as the control group. The control  group was also given a placebo; demographic characteristics, liver functions tests before and after the treatment, bilirubin decrease  rates, and hemogram parameters of groups were compared.

Results: Total bilirubin levels in the study and control groups before the  treatment were 16.02 ± 1.41 mg/dL and 15.93 ± 1.66 mg/dL, respectively (P = 0.84). Total bilirubin levels in the study and control groups at  day 7 after UDCA treatment were detected 8.18 ± 2.31 mg/dL and 13.92 ± 2.66 mg/dL, respectively (P < 0.001), and at day 14 after the  treatment were 5.45 ± 2.59 mg/dL and 11.91 ± 2.83 mg/dL, respectively (P < 0.001). Furthermore, serum aspartate aminotransferase (AST) was detected <21 U/L in the ROC analysis after UDCA treatment (P = 0.04).

Conclusion: The study outcomes indicated that an efficient  reduction in total bilirubin levels may be achieved, and outpatient clinic follow-up period may be reduced in patients whom UDCA was  administrated. Moreover, it may be speculated that AST can be used to evaluate the efficacy after treatment. However, studies with larger  sample sizes are needed for the routine use of UDCA in the treatment of prolonged jaundice.