A multiple logistic regression model demonstrated that direct Coombs positivity (OR 2.6, 95% CI 1.45–4.8, p = 0.001), reticulocyte count ≥7% (OR 7.1, 95% CI 3.7–13.4, p = 0.001), and a bilirubin/albumin ratio ≥6.5 (OR 19.8, 95% CI 11.8–33.4, p = 0.001) were independently associated with an increased risk for exchange transfusion in infants with hyperbilirubinemia. This evidence concerns the gene ALB and Hyperbilirubinemia.