Clinico-etiological profile of neonates with jaundice in a tertiary care hospital of Northernmost India

Bashir U. Zaman; Parvez Ahmed Lone; Irtika; Naseer Yousuf Mir

doi:10.18203/2349-3291.ijcp20241038

Authors

Bashir U. Zaman Department of Pediatrics, Government Medical College Srinagar, Jammu and Kashmir, India
Parvez Ahmed Lone Department of Pediatrics, Government Medical College Srinagar, Jammu and Kashmir, India
Irtika Department of Obstetrics and Gynecology, Government Medical College Srinagar, Jammu and Kashmir, India
Naseer Yousuf Mir Department of Pediatrics, Government Medical College, Handwara, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20241038

Keywords:

ABO incompatibility, Neonatal hyperbilirubinemia, Physiological jaundice, Rh incompatibility

Abstract

Background: Neonatal jaundice is the most common problem in the first week of life leading to delayed hospital discharges and readmissions. Recognizing early neonatal hyperbilirubinemia plays a pivotal role in preventing serious complications. The aim of this study was to study the clinical profile and etiological factors leading to neonatal jaundice.

Methods: This prospective observational study was conducted in the neonatal intensive care unit (NICU), department of pediatrics, government medical college, Srinagar, Jammu and Kashmir, India over a period of 6 months (August 2023 to January 2024). A total of 400 cases were enrolled for the study. Data collection was done by history taking, clinical examination and relevant laboratory investigations.

Results: In this study, out of 400 jaundiced neonates, 236 (59%) were males and 164 (41%) were females, 342 (85.5%) were born at term and remaining 58 (14.5%) were preterm babies. Among 400 neonates studied, majority (80%) had birth weight ≥2500 gm. Only 80 (20%) had birth weight less than 2500 gm. Physiological jaundice was seen in 162 (40.5%) of the total cases. This was followed by ABO incompatibility (20%), Rh incompatibility (16.5%), sepsis (8%), idiopathic (5%), prematurity (4%), cephalhematoma (4%) and breastfeeding jaundice (2%).

Conclusions: This study concludes that physiological jaundice is the most common cause of neonatal jaundice in our hospital. This was followed by ABO incompatibility, Rh incompatibility and sepsis. This highlights the importance of appropriate monitoring of neonates with these underlying risk factors.

Metrics

Metrics Loading ...

References

Stevenson DK, Madan A. Jaundice in newborn. In: Rudolph CD, Rudolph AM, Hostetter MK, Lister G, Siegel NJ, editors. Rudolph’s pediatric. 23st ed, McGraw Hill. 2018.

Barbara JS, Kliegman RM. Jaundice and hyperbilirubinemia in the newborn. In: Kliegman RM, Behrman HB, Jenson HB, editors. Nelson textbook of paediatrics, 17th ed. Philadelphia: Elsevier Saunders. 2004;592-8.

Bhutani VK, Zipursky A, Blencowe H, Khanna R, Sgro M, Ebbesen F, et al. Neonatal hyperbilirubinemia and Rhesus disease of the newborn: incidence and impairment estimates for 2010 at regional and global levels. Pediatr Res. 2013;74(1):86-100.

Mwaniki MK, Atieno M, Lawn JE, Newton CRJC. Long-term neurodevelopmental outcomes after intrauterine and neonatal insults: A Systematic review. Lancet. 2012;379(9814):445-52.

Brouillard R. Measurement red blood cell life-span. J AM Med Assoc. 1974;230(9):1304-5.

Maisels MJ, Watchko JF, Bhutani VK, Stevenson DK. An approach to the management of hyperbilirubinemia in the preterm infant less than 35 weeks of gestation. J Perinatol. 2012;32(9):660-4.

Stokowski, Laura A. Fundamentals of phototherapy for neonatal jaundice. Adv Neonatal Care. 2011;11(5):S10-21.

Narang A, Kumar P, Kumar R. Neonatal jaundice in very low birth weight babies. Indian J Pediatr. 2001;68:307-309.

Mishra S, Agarwal R, Deorari AK, Paul VK. Jaundice in the newborns. Indian J Pediatr. 2008;75(2):157-63.

Maisels MJ, Bhutani VK, Bogen D, Newman TB, Stark AR, Watchko JF. Hyperbilirubinemia in the newborn infants >35 weeks gestation: an update with clarifications. Pediatrics. 2009;124(4):1193-8.

Ipek IO, Bozayakut A Clinically significant neonatal hyperbilirubinemia: an analysis of 546 cases in Istanbul. J Trop Pediatr. 2008;54(3):212-3.

Olusanya BO, Osibanjo FB, Slusher TM. Risk factors for severe neonatal hyperbilirubinemia in low and middle-income countries: a systematic review and Meta-analysis. PLoS One. 2015;10(2):e0117229.

Effiong CE. Neonatal jaundice in Ibadan. Incidence and etiologic factors born in hospital, Nigeria. J National Med Asso. 1975;67(3):208-10.

Narang A, Ghatwala G, Kumar P. Neonatal jaundice, an analysis of 551 cases. Indian Paediatr. 1996;34:429-32.

Korejo H. Risk factors for kernicterus in neonatal jaundice, Karachi, Pakistan. GJMS. 2010;8(1):12-4.

Bhutani VK. Evidence based issues regarding neonatal hyperbilirubinemia. Paediatr Rev. 2005;114(1):130-53.

Singhal PK, Singh M, Paul VK, Deorari AK, Ghorpade MG. Spectrum of neonatal hyperbilirubinemia: An analysis of 454 cases. Indian Pediatr. 1992;29(3):319-25.

Bahl L, Sharma R, Sharma J. Aetiology of neonatal jaundice at Shimla. Indian Paediatr. 1994;31(10):1275-8.

Merchant RH, Merchant SM, Babar ST. A study of 75 cases of neonatal jaundice. Indian Pediatr. 1975;12(9):889-93.

Manorama V, Chatwal J, Singh D. Neonatal hyperbilirubinemia, Indian J Paediatr. 1988;55(6):899-904.

Bajpai PC, Mishra PK, Agarwal M. An aetiological study of neonatal hyperbilirbinemia. Indian J Pediatr. 1971;38(286):424-9.

Moerschel SK, Cianciaruso LB, Tracy LR. A practical approach to neonatal jaundice. Am Fam Physician. 2008;77(9):1255-62.

Khattak ID, Khan TM, Khan P, Shah SMA, Khattak ST, Ali A. Frequency of ABO and rhesus blood groups in district Swat, Pakistan. J Ayub Med Coll. 2008;20(4):127-9.