Evaluation of hospitalized newborns due to indirect hyperbilirubinemia: A cross-sectional study

Abstract

Aim: Indirect hyperbilirubinemia, a widespread problem in the newborn period, may need emergency treatment for prevention of neurological sequelae and mortality in some cases. We aimed to report the incidence, etiological factors, clinical findings, and the treatment of neonates with indirect hyperbilirubinemia. Methods: Ninety-six cases of non-physiological indirect hyperbilirubinemia and prolonged jaundice which were followed-up in the Neonatology Unit of Kafkas University Hospital between January 2018-October 2019 were evaluated. The therapeutic approach was determined according to the recommendations of American Academy of Pediatrics in 2004. Results: The incidence of IHB was 24.8% (n=96) among 387 hospitalized neonates. The mean gestational age, birth weight (BW), and bilirubin level on admission were 36.2 (2.5) weeks, 2628.9 (820) g, and 12.1 (5.29) mg/dL, respectively. Among all, vaginal delivery ratio was 38.5%, and cesarean delivery rate was 61.5%. About 34.4% were first-time mothers. The rates of breastfeeding and formula feeding were 39.6% and 1%, respectively. Around 59.4% were both breast-and formula-fed. The etiological factors of IHB were as follows: Prematurity and/or low birth weight (LBW) (20.9%), breast feeding jaundice (8.3%), ABO incompatibility (17.7%), Rh incompatibility (7.3%), ABO+Rh incompatibility (3.1%), cephal hematoma (2.1%), urinary infection (4.2%), sepsis (4.2%), pneumonia (2.1%), omphalitis (1%), subgroup incompatibility (1%), Glucose 6 phosphate dehydrogenase deficiency (1%) and unknown etiology (7.3%). Exchange transfusion rate was 1% (n=1), and 5 neonates (5.2%) were administered immunoglobulin therapy among 27 (28.1%) with hemolytic hyperbilirubinemia. Conclusion: Indirect hyperbilirubinemia is an important risk factor for mortality and morbidity in newborn period. Defining the risk factors for non-physiologic indirect hyperbilirubinemia, adequate follow up and prompt treatment would reduce neurological sequelae and mortality rates.