Factors identifying babies at risk for significant hyperbilirubinemia: a prospective study conducted at a tertiary care center

Abstract

INTRODUCTION Hyperbilirubinemia is universally present in the newborn period and is recognized as clinical jaundice in approximately 50% infants. The sheer prevalence of neonatal jaundice and periodic occurrence of bilirubin associated encephalopathy ensures sustained interest in this subject. The fear for the level of 20 mg/dl has given anxious moments to doctors and the relatives of the "jaundiced infant". To the pediatrician jaundice remains ABSTRACT Background: Hyperbilirubinemia is universally present in the newborn period and is recognized as clinical jaundice in approximately 50% infants. The aim was to determine the risk factors and treatment modalities of newborns with significant hyperbilirubinemia admitted from September 2011 to August 2013. Methods: One hundred and fifty newborns with significant hyperbilirubinemia, both inborn and outborn were included in the study. Relevent information during hospitalisation was taken. American Academy of Pediatrics (AAP) guidelines were followed to determine the treatment modality. Treatment in the form of either phototherapy or exchange transfusion was given. Results: Out of 150 patients 90 were males and 60 females. Higher values of serum bilirubin were found in the female babies and this difference was statistically significant. One hundred and thirty four babies had a birth weight of more than 2 kgs and 16 less than 2 kgs. The serum bilirubin levels were more in babies more than 2 kgs and this was statistically significant. Ninety one babies were delivered vaginally and 59 by LSCS. Higher serum bilirubin levels were found in those delivered vaginally with the difference being statistically significant .ABO blood group incompatibility was seen in 70 babies, 6 babies with Rh incompatibility. ABO incompatibility resulted in higher serum bilirubin levels with the difference being statistically significant. Ninety six babies had a gestation of more than 37weeks and higher bilirubin levels were found in this group as compared to lesser gestational age baby, the difference was statistically significant. Eighty five patients were admitted before 72 hours of life and 65 after that. Higher serum bilirubin levels were found in those admitted later with a statistically significant difference. The presence of antenatal risk factors (P = 0.4), parity of the mother (P = 0.178) were not found to play a major role in development of significant hyperbilirubinemia. Phototherapy was used as treatment modality in 137 pati…