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Risk Factors for Severe Hyperbilirubinemia and Exchange Transfusion in Neonates | ||
| Kirkuk Journal of Medical Sciences | ||
| Article 4, Volume 11, Issue 2, October 2023, Pages 42-50 PDF (1.03 M) | ||
| Document Type: Original research | ||
| DOI: 10.32894/kjms.2023.137427.1051 | ||
| Author | ||
| Noorjan Mohammed* | ||
| Kirkuk University College of Medicine | ||
| Abstract | ||
| Background: Neonatal jaundice is a frequent cause of hospital admission. Its incidence has increased in the last decade, affecting 65% of term babies and 80% of preterm babies. This study aims to identify risk factors for severe hyperbilirubinemia and exchange transfusion in neonates. Methods: In Kirkuk city, a prospective follow-up study was conducted in the neonatal care unit (NCU) of Azadi Teaching Hospital from 1st June 2019, to 1st June One hundred and sixty-four neonates with hyperbilirubinemia were enrolled. Relevant data were collected upon hospital admission, and patient management followed by American Academy of Pediatrics (AAP) guidelines, utilizing either phototherapy or exchange transfusion with phototherapy. Result: Among 164 cases, the mean TSB level was 16.6 mg/dL. Significant TSB elevations were seen in male neonates, Rh-negative mothers with Rh-positive babies, >37 weeks' gestation, admission after 72 hours, history of affected siblings or received phototherapy, and family history of hemolytic diseases. Mode of delivery, birth weight, cephalohematoma, infants of diabetic mothers, and feeding types were not significant. Phototherapy was primary treatment. Infants needing exchange transfusion had mean age 4.97 ± 2.24 days at NCU admission, TSB level 20.2 ± 2.84 mg/dL. Leading causes for ET were early maternity discharge and delayed NCU admission (72.4%). Conclusions: Neonatal severe hyperbilirubinemia was more prevalent in male neonates born >37 weeks, with Rh-negative mothers and Rh-positive babies, admitted after 72 hours, with a family history of hemolytic diseases, affected siblings, or received phototherapy. Phototherapy was the primary treatment, while the leading cause of ET was early maternity discharge and delayed NCU admission. | ||
| Keywords | ||
| Neonatal hyperbilirubinemia; Risk factors; Exchange transfusion | ||
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