The risk factors for significant non-hemolytic neonatal hyperbilirubinemia in Duhok

الملخص EN

Background: Jaundice is a common neonatal problem.

Sixty-five percent of newborns develop clinical jaundice with a bilirubin level above 5 mg/dL during the first week of life.

Bilirubin is a potent antioxidant that may help the newborn who is deficient in most antioxidant substances.

Hyperbilirubinemia can also be toxic with high levels resulting in an encephalopathy.

Identifying infants at risk of developing severe neonatal hyperbilirubinemia and kernicterus is a problem that clinicians have faced since the condition of neonatal jaundice initially was recognized more than 100 years ago.

Aim: To assess the important risk factors for significant neonatal hyperbilirubinemia in Duhok , Iraq Kurdistan Region.

Methods: The study included 160 cases of non–hemolytic neonatal hyperbilirubinemia that needed management with phototherapy or exchange transfusion and 260 controls who were neonates without significant hyperbilirubinemia.

Both groups were studied in terms of the maturity, type of feeding, use of oxytocin to induce labor, the presence of cephalhematoma and or bruises and a family history of a sibling who had significant hyperbiliribinemia and results were statistically analyzed using Chi-square test where P less than 0.05 is significant.

Results: Prematurity was present in 71 cases (44%) and 47controls (18%) P <0.001, Birth weight <2500 grams was present in 76 cases (47%) and 78control (30%) P <0.001, Breast feeding was present in 64 cases (40%) and 123 controls (47%) P <0.001, oxytocin was used in 79 cases (49%) and 173 controls (67%) P <0.001,Cephalhematoma was present in 12 cases (8%) and 42 controls (16%) P = 0.015, family history of a sibling with significant hyperbilirubinemia was present in 16 cases (10%) and 10 controls (4%) P= 0.02 Discussion and conclusion: By statistical analysis it was found that prematurity, low birth weight (< 2.5 kg), breast feeding, use of oxytocin to induce labor, the presence of cephalhematoma and/or bruises and a sibling with history of significant hyperbilirubinemia are all significant predisposing factors as agrees with many studies done allover the world.