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Not yet recruitingNCT07694635Updated Jul 13, 2026

Predictors of Rebound Hyperbilirubinemia Study

An observational study in Neonatal Hyperbilirubinemia and Rebound Hyperbilirubinemia, sponsored by Haseki Training and Research Hospital. Not yet recruiting at 1 site in Turkey (Türkiye). Open to participants aged 2 Hours to 28 Days. Per ClinicalTrials.gov, last updated 2026-07-13.

Sponsored by Haseki Training and Research Hospital · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
300
Ages
2 Hours to 28 Days
Sex
All
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Study summary

## Brief Summary

Neonatal hyperbilirubinemia is one of the most common causes of neonatal hospitalization and phototherapy treatment. Although phototherapy is highly effective, rebound hyperbilirubinemia following discontinuation of phototherapy may occur in some infants and may require repeat treatment. Early identification of neonates at risk for clinically significant rebound hyperbilirubinemia could help optimize discharge timing and reduce unnecessary hospital stay and repeat bilirubin testing.

This prospective observational study aims to evaluate the predictors of rebound hyperbilirubinemia after phototherapy discontinuation in neonates admitted to the NICU. Particular focus will be placed on the role of delta total serum bilirubin (ΔTSB), defined as the difference between the phototherapy threshold and the measured bilirubin level at the time of phototherapy discontinuation. Clinical, demographic, laboratory, hemolytic, feeding-related, and phototherapy-related variables will also be analyzed.

The primary outcome will be clinically significant rebound hyperbilirubinemia requiring repeat phototherapy within 24-48 hours after discontinuation of the initial phototherapy treatment. Secondary outcomes include rebound bilirubin levels, duration of hospitalization, and factors associated with repeat phototherapy.

Read the detailed description

## Detailed Description

Neonatal hyperbilirubinemia remains one of the leading causes of neonatal hospitalization worldwide. Phototherapy is the standard treatment for significant unconjugated hyperbilirubinemia and is highly effective in reducing serum bilirubin levels. However, a subset of neonates may develop rebound hyperbilirubinemia after discontinuation of phototherapy, occasionally requiring repeat phototherapy and prolonged hospitalization.

Current evidence regarding predictors of rebound hyperbilirubinemia remains limited, particularly in prospective NICU-based cohorts. Identification of infants at increased risk for clinically significant rebound hyperbilirubinemia may improve individualized monitoring strategies, optimize timing of discharge, and reduce unnecessary bilirubin measurements and hospital stay.

This prospective observational study will include neonates admitted to the NICU and treated with phototherapy for hyperbilirubinemia. Clinical and laboratory parameters associated with rebound hyperbilirubinemia will be evaluated. Special emphasis will be placed on delta total serum bilirubin (ΔTSB), defined as the difference between the phototherapy threshold recommended by current guidelines and the measured total serum bilirubin level at the time of phototherapy discontinuation.

Additional variables including gestational age, postnatal age at phototherapy initiation, feeding type, hemolytic risk factors, bilirubin kinetics, and phototherapy characteristics will also be analyzed. Rebound bilirubin measurements will be obtained within 24-48 hours after discontinuation of phototherapy according to unit protocol.

The primary objective is to determine predictors of clinically significant rebound hyperbilirubinemia requiring repeat phototherapy. Secondary objectives include evaluation of bilirubin rebound levels, hospitalization duration, and the association between phototherapy characteristics and rebound risk.

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Conditions studied

  • Neonatal Hyperbilirubinemia
  • Rebound Hyperbilirubinemia

Keywords

  • Rebound Hyperbilirubinemia
  • Neonatal Jaundice
  • Phototherapy
  • Neonate
  • Repeat Phototherapy
03

In context

Hyperbilirubinemia, Neonatal

96 studies on the registry are indexed under Hyperbilirubinemia, Neonatal; 20 are open to participants now.

This study's planned enrollment of 300 is close to the median of 300 across 31 observational studies indexed under Hyperbilirubinemia, Neonatal.

Browse Hyperbilirubinemia, Neonatal studies →

Lead sponsor

Haseki Training and Research Hospital is the lead sponsor of 78 studies on the registry; 17 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
2 Hours to 28 Days
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

The study population consists of neonates admitted to the NICU for neonatal hyperbilirubinemia and treated with phototherapy according to institutional protocols and current guideline-based phototherapy thresholds. Both standard and intensive phototherapy modalities may be used based on bilirubin levels, gestational age, and neurotoxicity risk factors.

Eligible neonates will be prospectively followed after discontinuation of phototherapy for evaluation of rebound hyperbilirubinemia and repeat phototherapy requirement. Clinical, laboratory, hemolytic, feeding-related, and phototherapy-related variables will be recorded and analyzed to identify predictors of clinically significant rebound hyperbilirubinemia.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Neonates admitted to the NICU with neonatal hyperbilirubinemia
  • Gestational age ≥35 weeks
  • Requirement for phototherapy according to institutional protocol and current guideline-based phototherapy thresholds
  • Receipt of standard and/or intensive phototherapy
  • Availability of measurements before, during, and after phototherapy
  • Availability of rebound bilirubin measurement within 48 hours after phototherapy discontinuation
  • Written obtained from parents or legal guardians, if required by the ethics committee

Exclusion criteria

Exclusion Criteria:

  • Major congenital anomalies
  • Conjugated hyperbilirubinemia
  • Neonates requiring exchange transfusion before completion of initial phototherapy
  • Severe perinatal asphyxia
  • Proven or suspected inborn errors of metabolism affecting metabolism
  • Significant congenital liver disease
  • Neonates transferred to another center before completion of rebound bilirubin follow-up
  • Missing or incomplete clinical or laboratory data
  • Absence of rebound bilirubin measurement within 48 hours after phototherapy discontinuation
  • Parents or legal guardians declining participation, if consent is required
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

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Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
300 participants (estimated)
Target follow-up
2 Days
Patient registry
Yes

Groups and cohorts

  • Neonates Receiving Phototherapy

    This cohort includes neonates admitted to the NICU and treated with phototherapy for neonatal hyperbilirubinemia according to current institutional protocols and guideline-based phototherapy thresholds. Both standard and intensive phototherapy modalities may be used depending on bilirubin levels, gestational age, and neurotoxicity risk factors. Phototherapy is administered using Astek phototherapy devices and/or tunnel phototherapy systems, either as single-device or double-device therapy. Irradiance intensity may be adjusted according to clinical severity. Phototherapy is applied continuously except during feeding and routine care intervals. Serum bilirubin levels are monitored during and after phototherapy according to unit protocol. Rebound bilirubin measurements are routinely obtained after discontinuation of phototherapy, and additional measurements are performed in neonates considered at increased risk for rebound hyperbilirubinemia. Clinical, labo

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What researchers measure

Primary outcomes

  1. Clinically Significant Rebound Hyperbilirubinemia Requiring Repeat Phototherapy

    Clinically significant rebound hyperbilirubinemia is defined as an increase in total serum bilirubin after discontinuation of initial phototherapy that reaches the guideline-based phototherapy threshold and requires initiation of repeat phototherapy.

    Time frame: Within 48 hours after phototherapy discontinuation

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Study locations

1 site
  • University of Health Sciences, Haseki Training and Research Hospital
    Istanbul, Sultangazi 34265, Turkey (Türkiye)
08

References and documents

Publications

  • Donneborg ML, Thorsteinsson K, Bruun NH, Ebbesen F. Short-time intensive phototherapy of hyperbilirubinemic neonates: efficacy, bilirubin rebound and risk factors for rebound. Pediatr Res. 2026 Feb 28. doi: 10.1038/s41390-026-04870-3. Online ahead of print. PubMed 41760910 ↗

Individual participant data

Plan to share: No — Individual participant data (IPD) will not be publicly shared because the study involves sensitive neonatal clinical data obtained from a single-center NICU cohort. Data sharing may be restricted by institutional policies and ethical considerations regarding patient confidentiality and privacy. Aggregated and anonymized study results will be presented in scientific publications and presentations.

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Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Jun 2026; primary completion for Oct 2026, 4 months later.

Of 15 observational studies under Hyperbilirubinemia, Neonatal, half reached primary completion within 20 months of starting (the median), counting those still running; a quarter within 6 and three quarters within 59. This study's planned 4 months is below that.

How these figures are worked out, and which studies are left out of them.

Registered
Jul 3, 2026
First posted
Jul 10, 2026
StartEst.
Jun 15, 2026
Primary completionEst.
Oct 2026
CompletionEst.
Nov 2026
Last update
Jul 13, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jul 13, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT07694635
Lead sponsor
Haseki Training and Research Hospital
Responsible party
Berker Okay (M.D, Haseki Training and Research Hospital) — Principal investigator
First posted
Jul 10, 2026
Start date
Jun 15, 2026 (estimated)
Primary completion
Oct 2026 (estimated)
Completion
Nov 2026 (estimated)
Last update
Jul 13, 2026

Study contacts

Dilek Kurnaz, M.D
Contact
drdilekkurnaz@gmail.com
+905556119280
Dilek Kurnaz, M.D
principal investigator · Health Sciences University, Haseki Training and Research Hospital

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Jul 2026. You cannot join it, but the record below documents what was studied.

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