Indirect neonatal hyperbilirubinemia and associated risk factors for long phototheraphy duration in a baby-friendly hospital in Konya, Turkey

Aim: Indirect neonatal hyperbilirubinemia is a common neonatal disorder worldwide which can remain benign if prompt management is available. However there is a higher morbidity and mortality risk in settings with limited access to diagnosis and care. The aim of this study was to evaluate the etiologies of indirect neonatal hyperbilirubinemia, to determine the effectiveness of phototherapy treatment and to specify the associated risk factors for prolonged phototherapy duration. Materials and Method: Infants with ≥37 weeks of gestation, postnatal age of ≤14 days, and diagnosis of hyperbilirubinemia at admission, defined as serum bilirubin level at or above the phototherapy treatment threshold were included in the study. All the study participants were treated with intermittent phototherapy. The data were retrospectively analized and duration of phototherapy was classified as ≤24 hours (early discharge) and >24 hours (late discharge). Results: A total of 205 newborns were included in the study. The mean birth weight was 3171.12±436.19 g and mean gestational age was 38.87±1.18 (37–39) weeks. Also, ABO incompatibility and cephalic hematoma were found to be the most common etiologies in our series. On the other hand, male gender (p=0.03) and formula as the first prelacteal feeds (p=0.03) were significantly higher in late discharge group. Additionally; male gender, formula as the first prelacteal feed, ABO incompatibility, Rh isoimmunization, cephalic hematoma and sepsis were risk factors for long phototherapy duration of >24 hours. Discussion and Conclusion: Determination of possible risk factors for neonatal jaundice can provide early hospital admissions by informing mothers before discharge after birth