A prospective study on etiological factors and clinical indicators in term and near term neonates admitted with hyperbilirubinemia in nicu in a tertiary care hospital in Hyderabad, India

Abstract

1.To study the etiology and risk factors of neonatal hyperbilirubinemia in term and near-term infants. 2. To study the clinical course of these infants during NICU stayThe present study was conducted at NICU, Department of Pediatrics, Princess Esra hospital, Deccan Medical College, Hyderabad, India, from October 2019 to October 2020. Term and late preterm infants admitted in NICU with Serum Bilirubin levels more than 12mg/dl were included in the study. The risk factors, etiology and clinical profile of these infants during NICU stay were studied. 210 neonates were admitted in NICU with hyperbilirubinemia (Serum Bilirubin >12mg/dl) during the study period, out of which 118 were male (56.20%) and 92 were female (43.80%). Neonates were further distributed based on gestational age, in which 46 (21.90%) were late pre-terms i.e. between 34-37 weeks and 164 neonates (78.10%) were full term i.e. greater than 37 weeks. The neonates were also classified based on their birth weight, with neonates between 2500-3000 grams having the highest incidence (46.19%). Lastly, the etiological and risk factors were assessed and quantified, with physiological jaundice occurring as the major cause and late prematurity as the most common risk factor associated with neonatal hyperbilirubinemia. The average duration of phototherapy was 2.50 days and 3 babies required Double Volume Exchange Transfusion (DVET) for significant hyperbilirubinemia.None of the babies requiring DVET had clinical features of Bilirubin Induced Neurological Dysfunction (BIND) during NICU stay. 1. Most common cause of neonatal hyperbilirubinemia was found to be Physiological followed by Septicemia and Idiopathic etiologies. Blood group incompatibilities were less common causes. 2. Phototherapy is a cheap and effective way to reduce bilirubin levels in neonatal jaundice. 3. Exchange transfusion is a safe procedure and should be considered when indicated, to decrease the incidence of BIND. All cases requiring DVET were due to blood group incompatibility.