Etiological study of jaundice in neonates

Authors

  • Jasraj Bohra Department of Pediatrics, Government Medical College, Barmer, Rajasthan, India
  • Chuba Kumzuk L. C. R. Department of Pediatrics, Nagaland Multi Speciality Hospital, Duncan Bosti, Dimapur, Nagaland, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20193600

Keywords:

ABO incompatibility, Exaggerated physiological jaundice, Kernicterus, Neonatal jaundice, Prematurity, Rh-incompatibility

Abstract

: Jaundice is the commonest abnormal finding with an incidence of about 60% in term babies and 80% in preterm babies. It is the commonest cause of admission to hospitals in the newborn period. In preterm babies, the percentage is exceedingly high due to their physiological handicaps and other hazards of prematurity like Asphyxia, septicemia, respiratory and circulatory Insufficiency. Non-physiological or pathological jaundice is also known to occur in (8-9)% of newborns. Its timely detection and optimal management are crucial to prevent brain damage and subsequent neuro-motor retardation. Aims of this study to find out the etiology of jaundice in neonates, admitted in neonates unit attached to SMS medical college Jaipur.

Method: This Observational study was conducted in Neonatal Intensive Care Unit (NICU) and Post Natal Ward attached to SMS medical college Jaipur, after approval from the hospital ethical committee, over a period of 12 months(October 2011 to September 2012. Study was carried on 500 neonates presenting clinically with neonatal hyperbilirubinemia.

Result: The onset of jaundice was seen maximum between live hour 24-72 hours (n=290, 58% cases), followed by live hour 72 hours-14 days (n=160, 32%). At more than 2 weeks there was only 3 case (0.6%). The etiological factors in the causation of jaundice in the decreasing order of frequency were exaggerated physiological jaundice accounts for (28%), ABO-incompatibility (24.4%), Rh-incompatibility (13.8%), Idiopathic (10.4%), cephalhematoma (10.2%), septicemia (6%), intrauterine infections (4%), BMJ (1.8%), Galactocemia (0.8%) and G6PD  Deficiency (0.6%) respectively.

Conclusion: Hyperbilirubinemia is more severe in newborns, therefore precautionary measure should be adopted by both parents, and clinicians to diagnose and treat the diseases properly.

References

Porter ML, Dennis BL, Hyperbilirubinemia in Term Newborn, Am Fam Physician. 2002 Feb 15;65(4):599-606.

Phyllis D, Seidman DS. Neonatal hyperbilirubinemia, New England J Med. 2001 March;344(8):581-90.

Kramer LI. Advancement of dermal icterus in the jaundiced newborn. Am J Diseas Children. 1969 Sep 1;118(3):454-8.

Moyer VA, Ahn C, Sneed S. Accuracy of clinical judgment in neonatal jaundice. Archives of pediatr & adolescent medic. 2000 Apr 1;154(4):391-4.

Effiong CE, Aimaku VE, Bienzle U, Oyedeji GA, Ikpe DE. Neonatal jaundice in Ibadan. Incidence and etiologic factors in babies born in hospital. J the National Medical Association. 1975 May;67(3):208-10.

Narang A, Kumar P, Kumar R. Neonatal jaundice in very low birth weight babies. Ind J Pediatr. 2001 Apr 1;68(4):307-9.

Korejo HB, Bhurgri GR, Bhand S, Qureshi MA, Dahri GM, Chohan RK. Risk factors for kernicterus in neonatal jaundice. Gomal J Med Scien. 2010 Jun 1;8(1).

Bhutani VK. Evidence based issues regarding neonatal hyperbilirubinemia. Pediatr rev. 2005; 114:130-153.

Bajpai PC, Misra PK, Agarwal M, Engineer AD. An etiological study of neonatal hyperbilirubinaemia. Ind J Pediatr. 1971 Nov 1;38(11):424-9.

Onyearugha CN, Onyire BN, Ugboma HAA. Neonatal Jaundice: prevalence and associated factors as seen in Federal Medical Centre Abakaliki, Southeast Nigeria. J clinical med and research; 2011 Mar 31;3(3):40-5.

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

Korejo HB, Bhurgri GR, Bhand S, Qureshi MA, Dahri GM, Chohan RK. Risk factors for kernicterus in neonatal jaundice. GJMS. 2010 Jun 1;8(1).

Anand VR, Magotra ML. Neonatal jaundice: its incidence and aetiology. Indian pediatrics. 1978 Feb;15(2):155-60.

Bahl LA, Sharma RA, Sharma JA. Etiology of neonatal jaundice at Shimla. Indian pediatrics. 1994 Oct 1;31(10):1275-8.

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

Zabeen B, Nahar J, Nabi N, Baki A, Tayyeb S, Azad K, et al,. Risk factors and outcome of neonatal jaundice in a tertiary hospital. IMCJ. 2010;4(2):70-3.

Narang A, Gathwala G, Kumar P. Neonatal jaundice: an analysis of 551 cases. Indian pediatr. 1997 May;34:429-32.

Cheng SW, Chiu YW, Weng YH. Etiological analyses of marked neonatal hyperbilirubinemia in a single institution in Taiwan. Chang Gung Med J. 2012 Mar 1;35(2):148-54.

Heydarian F, Majdi M. Severe neonatal hyperbillirubinemia cause and contributing factor lead to exchange tranfusion at Ghaem Hospital in Mashhad. Acta Med Iran. 2010 Nov-Dec;48(6):399-402.

Joshi BD, Singh R, Mahato D. Clinico-laboratory profile of neonatal hyper-bilirubinemia in term babies at B.P. Koirala institute of health science, Dharan, Nepal, JNHRC 2004;2:30-2.

Sgro M, Campbell D, Shah V. Incidence and causes of severe neonatal Hyperbilirubinemia in Canada. CMAJ 2006;175(6):587-90.

Hyatt Sr HW. Hyperbilirubinemia in a Newborn Infant Probably Related to Cephalhematoma. J National Med Assoc. 1964 Jul;56(4):329.

Downloads

Published

2019-08-23

Issue

Section

Original Research Articles