Background: Hyperbilirubinemia is the most common condition requiring evaluation and treatment in newborns. It must be treated early to avoid development of kernicterus. Management of unconjugated hyperbilirubinemia is clearly tied to the etiology. Early identification of known causes of non-physiologic hyperbilirubinemia should prompt appropriate laboratory investigations, and timely intervention.
Objectives: to make a survey to all jaundiced baby admitted to NICU to determine the different causes of neonatal hyperbilirubinemia, the different modalities of treatment and the risk factors for developing complications.
Patients & Methods: This study was an analytic observational study included all neonates presented by neonatal hyperbilirubinemia admitted to the NICU of Bab Alsharyia University Hospital over one year period from January 2019 to January 2020, the study included 260 neonates (142 males, and 118 females) with mean gestational age was 37.25 ± 0.91 weeks.
Results: neonatal jaundice in admitted cases was 54.6% in males and 45.4% in females. 19.2% of the cases were vaginally delivered and 80.8% were delivered by caesarean section. The mean gestational age was 37.25 ± 0.91 weeks. The mean birth weight was 2.79 ± 0.68 kg. The mean age of onset of neonatal jaundice was 4.01 ± 3.64 day of life. The mean total bilirubin level at presentation was 17.13 ± 3.74 mg/dL. The mean maximum total bilirubin level was 25.76 ± 7.13 mg/dL. ABO incompatibility as a cause found in (32.7%) of cases, with more neonates having blood group A (45.3%) than those having blood group B (33.1%), Rh incompatibility in (4.6)% of cases , combined ABO and Rh incompatibility in (6.2%) of cases, breast milk in (38.1%), breast feeding (18.1%), biliary atresia (0.4%) of cases.
Conclusion: Neonatal hyperbilirubinemia still the most common cause of admission in NICU.Many etiological factors are associated with neonatal hyperbilirubinemia, mostly ABO incombatibility and breast milk jaundice .Early intensive phototherapy may restrict the need for blood exchange and its hazards.