Factors Associated with Neonatal Hyperbilirubinemia in Case Files of All Admitted Inborn and Outborn Neonates in Northwest Ethiopia in 2019

Document Type : Original Article

Authors

1 Department of Neonatal Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

2 Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

3 Department of Community Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

4 Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

Abstract

Background: Jaundice is a yellow discoloration of the skin and eyes caused by hyperbilirubinemia. Jaundice usually becomes visible on the sclera at a level of 2 to 3 mg/dL. Each year, about 1.1 million neonates develop hyperbilirubinemia in the world the vast majority of whom live in sub-Saharan Africa and South Asia. In 2016, neonatal jaundice was estimated to account for about 8 under-5 mortalities per 100,000 live births worldwide. This study aimed to assess the prevalence and associated factors of hyperbilirubinemia among all the inborn and outborn neonates at University of Gondar Comprehensive Specialized Hospital in Gondar, Ethiopia.
Methods: The current institutional-based retrospective cross-sectional study was conducted on 399 case files of all the admitted inborn and outborn neonates at University of Gondar Comprehensive Specialized Hospital within March 2017 to March 2019. The extracted data were entered into Epi Info software (version 7.0) and exported and analyzed using SPSS software (version 21.0). Variables with a p-value of less than 0.2 in the bivariate analysis were included in the final model, and the statistical significance was declared at less than 0.05. Both the size and statistically associated factors affecting the results of neonatal hyperbilirubinemia were the main outcome measures in this study.
Results: Overall, 31.6% (n=126) of the admitted neonates developed hyperbilirubinemia. Maternal and neonatal Rhesus (RH) incompatibility, ABO incompatibility, low birth weight, hypoglycemia, and birth trauma were the main statistically significant factors associated with neonatal hyperbilirubinemia.
Conclusion: The prevalence of neonatal hyperbilirubinemia in this study was high in comparison to that reported for other studies carried out on neonatal hyperbilirubinemia in some parts of Ethiopia. The major factors causing hyperbilirubinemia in neonates were RH incompatibility, low birth weight, birth trauma, and hypoglycemia. Therefore, by the early prevention and prompt treatment of hyperbilirubinemia in neonates, it is important to prevent or reduce both short-term and long-term complications related to this condition.
 
 

Keywords

References

  1. Chib R, Bhandari B. Clinico-demographic profile of hyperbilirubinemia in neonates admitted to a tertiary care hospital. Int J Contempor Pediatr. 2016; 3(2):328.
  2. American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbili-rubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2004; 114(1):297-316.
  3. American Academy of Pediatrics. Jaundice, what is jaundice? Philadelphia, PA: Elsevier Saunders; 2015.
  4. Sharma S. Neonatal hyperbilirubinemia: hospital based study in western region, Nepal. Janapriya J Interdisciplinary Stud. 2016; 5:75-82.
  5. Olusanya BO, Ogunlesi TA, Kumar P, Boo NY, Iskander IF, de Almeida MF, et al. Management of late-preterm and term infants with hyperbili-rubinemia in resource-constrained settings. BMC Pediatr. 2015; 15(1):39.
  6. Lake EA, Abera GB, Azeze GA, Gebeyew NA, Demissie BW. Magnitude of neonatal jaundice and its associated factor in neonatal intensive care units of Mekelle city public hospitals, Northern Ethiopia. Int J Pediatr. 2019; 2019:1054943.
  7. Olusanya BO, Teeple S, Kassebaum NJ. The contribution of neonatal jaundice to global child mortality: findings from the GBD 2016 study. Pediatrics. 2018; 141(2):e20171471.
  8. Shapiro SM, Bhutani VK, Johnson L. Hyperbili-rubinemia and kernicterus. Clin Perinatol. 2006; 33(2):387-410.
  9. Ogunlesi TA, Ogunfowora OB. Predictors of acute bilirubin encephalopathy among Nigerian term babies with moderate-to-severe hyperbilirubinemia. J Trop Pediatr. 2010; 57(2):80-6.

10. Maisels MJ. Neonatal jaundice. Pediatr Rev. 2006; 27(12):443-54.

11. Maisels MJ, Clune S, Coleman K, Gendelman B, Kendall A, McManus S, et al. The natural history of jaundice in predominantly breastfed infants. Pediatrics. 2014; 134(2):e340-5.

12. Stevenson DK, Dennery PA, Hintz SR. Understanding newborn jaundice. J Perinatol. 2001; 21(Suppl 1):S21-4.

13. Federal Democratic Republic of Ethiopia and Ministry of Health. National newborn and child survival strategy document brief summary, 2015-2020, Ethiopia: Postnatal Care; 2015.

14. Aydın M, Hardalaç F, Ural B, Karap S. Neonatal jaundice detection system. J Med Syst. 2016; 40(7):1-11.

15. Click R, Dahl-Smith J, Fowler L, DuBose J, Deneau-Saxton M, Herbert J. An osteopathic approach to reduction of readmissions for neonatal jaundice. Osteopathic Fam Phys. 2013; 5(1):17-23.

16. Kassa R, Gudeta H, Assen Z, Demlew T, Teshome G. Neonatal hyperbilirubinemia: magnitude and associated etiologic factors among neonates admitted at Tikur Anbessa specialized hospital, Ethiopia. J Preg Child Health. 2018; 5(384):2.

17. Mojtahedi SY, Izadi A, Seirafi G, Khedmat L, Tavakolizadeh R. Risk factors associated with neonatal jaundice: a cross-sectional study from Iran. Open Access Maced J Med Sci. 2018; 6(8):1387-93.

18. Omekwe DE, George MD, Kennis BT, Fakuma BN, Evdence CC, Destiny EF, et al. Survey and management outcome of neonatal jaundice from a developing tertiary health centre, Southern Nigeria. IOSR J Dental Med Sci. 2014; 13(4):35-9.

19. Onyearugha CN, Onyire BN, Ugboma HA. Neonatal jaundice: prevalence and associated factors as seen in Federal medical centre Abakaliki, Southeast Nigeria. J Clin Med Res. 2011; 3(3):40-5.

20. English M, Ngama M, Musumba C, Wamola B, Bwika J, Mohammed S, et al. Causes and outcome of young infant admissions to a Kenyan district hospital. Arch Dis Child. 2003; 88(5):438-43. 

Iranian Journal of Neonatology
Volume 12, Issue 1
January 2021
Pages 46-53

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