Occurrence of Hyperbilirubinaemia in New-Born Babies and Its Relation to Maternal Factors

Abstract

BACKGROUNDNeonatal Hyperbilirubinaemia (NNH) is a significant cause of neonatal morbidity and prolongation of hospital stay, which in turn increases the chances of sepsis and mortality in the new-born period. Identification of the risk factors and timely detection and optimal management of NNH are thus crucial to prevent brain damage and subsequent neuromotor retardation due to bilirubin encephalopathy. MATERIALS AND METHODSThis prospective study was carried out in M. G. M. Medical College and L. S. K. Hospital, Kishanganj (Bihar); 700 new-born babies delivered between December 2011 and June 2013, were included in the study. New-born babies who developed hyperbilirubinaemia were considered as 'CASE' and new-born babies with the same maternal factors, who did not develop hyperbilirubinaemia were considered as 'CONTROL;' 100 cases and 600 control patients were studied. All parameters were taken during the hospital stay of the mother and baby, which was 5 -7 days born (term and healthy babies are included only). Peripheral venous blood sample was drawn at the first appearance of significant clinical icterus according to Kramer's criteria. Serum bilirubin estimation was done in the Biochemistry Department of this hospital. RESULTSIncidence of NNH is 16.67% of all live-born babies in our hospital, which has an annual delivery rate of approx. 4000. We have noted that the incidence of jaundice of the cases of OA incompatibility, the percentage of babies who develop hyperbilirubinaemia is 20%. Of the cases of OB incompatibility, the percentage of babies who develop hyperbilirubinaemia is 23%. If we take ABO incompatibility together, the incidence of hyperbilirubinaemia is 7.17%. In our series, Rh incompatibility was 4.16% and can be reduced by religious use of anti-D gamma globulin (Rho GAM) in all deliveries and miscarriages in the Rh negative mothers. CONCLUSIONBlood group incompatibility as a whole is associated with increased incidence of hyperbilirubinaemia. ABO incompatibility does not have a significant impact on the incidence of NNH. Rh incompatibility is associated with increased incidence of neonatal hyperbilirubinaemia. Judicious use of inj. Anti-D immunoglobulins should be emphasised in suspected cases of Rh incompatibility to prevent NNH and its neurological effects. Early detection of maternal risk factors also should be done to prevent the development of NNH and kernicterus.