Etiological Factors of Neonatal Hyperbilirubinemia in Tribal Community of Meghalaya, India - A Cross-Sectional Study

Abstract

Objective: To identify the etiological factors of neonatal hyperbilirubinemia in tribal population of Meghalaya, India. Design: Cross sectional study. Setting: Neonatal intensive care unit under (level II NICU) Department of Paediatrics and Neonatology of Nazareth Hospital, Meghalaya, India. Participants: Neonates of Khasi, Jaintia and Garo tribes with neonatal jaundice admitted in NICU of Nazareth Hospital, Meghalaya, India. Main Outcome Measures: Demographic variables of the study population, Mean TSB values of various etiological factors, Effect of various etiological factors in early onset neonatal jaundice, Nature and duration of interventions needed for the neonates studied. Results: In 58.9% of the 409 neonates studied, no cause could be assigned for the development of jaundice. Of the remaining, 19.8% was attributed to low birth weight whereas 19% had ABO incompatibility and 10.8% were premature. 9.3% had sepsis, 8.5% had G6PD deciency while 3.2% were born to mothers with diabetes mellitus. Rh incompatibility was the causative factor in 1.7%. In 1.7%, pre-lacteal feed was associated with jaundice. In 62.3% of cases delayed cord clamping was found to be associated. Conclusions: Total serum bilirubin tends to be higher in female neonates, of term gestation, with birth weight 2500 g or above and with ABO incompatibility. Delayed initiation of breast feeding, those with positive history of neonatal jaundice in older siblings and those with proven neonatal sepsis were also found to have higher levels of bilirubin. Neonates who were given pre-lacteals and those born to diabetic mothers show lower mean total serum bilirubin levels. Most neonates who developed jaundice within 24 hours of life (early onset jaundice) had ABO incompatibility.