Factors associated with neonatal jaundice among neonates admitted to three hospitals in Burao, Somaliland: a facility-based unmatched case-control study

Abstract

Background: Neonatal jaundice is a common and potentially serious condition affecting newborns worldwide. This study aimed to identify factors associated with neonatal jaundice among neonates admitted to three hospitals in Burao, Somaliland. Methods: This hospital-based, unmatched retrospective case-control study was conducted between February and April 2025. Cases were neonates diagnosed with jaundice, whereas controls were neonates admitted without jaundice. Data were collected through maternal interviews and medical record reviews. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with neonatal jaundice. Results: A total of 320 neonates (64 cases and 256 controls) were included. Factors significantly associated with increased odds of neonatal jaundice were history of jaundice in previous siblings (AOR = 5.26, 95% CI: 2.16–12.84, p < 0.001), low birth weight < 2500 g (AOR = 2.40, 95% CI: 0.85–6.82, p < 0.05), and neonatal polycythemia (AOR = 6.27, 95% CI: 1.54–25.62, p = 0.011). Premature rupture of membranes showed a protective effect (AOR = 0.15, 95% CI: 0.03–0.83, p = 0.030). ABO incompatibility was more common in the cases (32.81%) than in the controls (18.36%, p = 0.011). The mean total serum bilirubin level among jaundiced neonates was 9.1 ± 6.4 mg/dL. Conclusions: This study identified key factors associated with neonatal jaundice in Burao, Somaliland. These findings emphasize the need for targeted monitoring of high-risk infants, particularly those with a family history of jaundice, low birth weight, or polycythemia. Strengthening protocols for the early detection and management of jaundice, improving maternal nutrition, and enhancing postnatal care could substantially reduce the burden of neonatal jaundice and its complications in this resource-limited setting.