Different causes of prolonged unconjugated Jaundice in the newborns

Vijay Agrawal, Alok Kumar Goyal, J. N. Sharma, Murli D. Yadav


Background: Prolonged unconjugated hyperbilirubinemia is a type of neonatal jaundice, which occurs in infants with high bilirubin levels (>10 mg/dl) persisting beyond 14-21 days. Prolonged unconjugated hyperbilirubinemia is a common problem among newborns, and the prevalence rate has been estimated at 2-15%. According to the literature, breastfeeding is a major cause of prolonged jaundice, and about 40% of infants who are exclusively breastfed are diagnosed with this disorder. Among other pathological causes associated with prolonged hyperbilirubinemia are urinary tract infection (UTI), congenital hypothyroidism and hemolysis. So, this study was done to know the different causes of unconjugated jaundice in newborn.

Methods: This Hospital based prospective descriptive study was carried out at outpatients and inpatients in the Department of pediatrics, SMS medical college Jaipur. Total 100 cases were taken and these neonates were evaluated to know different causes of unconjugated hyperbilirubenemia.

Results: Most common cause of persistent jaundice in both term and preterm babies is breast milk jaundice (66%), other causes include isoimmunization (10%), cephalhematoma (7%), hypothyroidism (7%), sepsis (4%) and ABO incompatibility (3%). Etiology of persistent jaundice was not significantly different in term and preterm babies.

Conclusions: Although breast milk jaundice is considered as a major cause of prolonged unconjugated hyperbilirubinemia in neonates, identification of other etiological factors, such as UTI, congenital hypothyroidism and hemolysis is also of paramount importance. Early diagnosis and treatment of these disorder could effectively prevent further complication in neonates. 


Breast feeding, Neonates, Sepsis, Unconjugated bilirubin

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