Association of Maternal Factors with hyperbilirubinaemia in Newborns at a Tertiary Care Hospital in Navi Mumbai, India: A Cross-sectional Study

Abstract

Introduction: Hyperbilirubinaemia in newborns is a common and serious condition, and it is also one of the most common causes of neonatal readmission to the hospital. It is challenging to diagnose or predict the onset of hyperbilirubinaemia in newborns. Therefore, identifying neonates with maternal risk factors is useful for early prediction of hyperbilirubinaemia, enabling effective management and prevention of complications such as acute bilirubin encephalopathy or kernicterus. Aim: To estimate the prevalence of neonatal hyperbilirubinaemia and its association with various maternal risk factors such as parity, maternal diseases, blood group incompatibility, mode of delivery, etc. Materials and Methods: This hospital-based descriptive, cross-sectional study was conducted at Dr. D.Y. Patil Hospital in Navi Mumbai, Maharashtra, India, from December 2021 to December 2022. A total of 500 healthy full-term neonates and their mothers were screened. Neonates with hyperbilirubinaemia during follow-up were evaluated. Data on maternal factors (e.g., parity, maternal diseases, polyhydramnios, premature rupture of membranes, ABO and Rh incompatibility) were collected, and their association with neonatal hyperbilirubinaemia was assessed. Statistical analysis of the data was performed using the Chi-square test to determine prevalence and significance. Results: Out of the 500 babies studied, 95 had serum total bilirubin levels beyond the acceptable normal level of 13 mg/dL at 72 hours of life. The prevalence of hyperbilirubinaemia was 19%. Among the 95 babies, 40 (42.1%) were born to primigravida mothers, while 55 (57.9%) were born to multigravida mothers. In the present study, the authors observed that out of the 26 mothers suffering from hypothyroidism, 14 babies developed hyperbilirubinaemia. Similarly, out of the 24 mothers with preeclampsia, eight babies developed hyperbilirubinaemia. Furthermore, out of the 15 mothers with diabetes mellitus, six babies developed hyperbilirubinaemia. Additionally, out of the 11 mothers with polyhydramnios, two babies developed hyperbilirubinaemia, and out of the 10 mothers with Premature Rupture of Membranes (PROM), one baby developed hyperbilirubinaemia. Among the 208 male neonates, 58 developed hyperbilirubinaemia, while among the 292 female neonates, 37 developed hyperbilirubinaemia. ABO incompatibility was seen in 23 (24.2%) neonates, and Rh incompatibility was seen in 3 (3.2%) neonates, both of which were identified as important risk factors. A higher incidence of hyperbilirubinaemia was observed in neonates born via Lower Segment Caesarean Section (LSCS) compared to normal vaginal delivery. Conclusion: In the present study, the prevalence of neonatal hyperbilirubinaemia was 19%. Male babies, babies born via LSCS, those with ABO incompatibility, and mothers with hypothyroidism were significantly more prone to develop hyperbilirubinaemia in neonates.