Epidemiologic Study of Jaundice in Newborns with Jaundice in the First 24 hours of Birth in Children's Hospital and Shariati Hospital of Bandar Abbas in 2010-2014
Author(s): Seyed Hossein Saadat, Salma Naderi, Shahram Zare, Samira Khalili, Behnaz Darban, Rakhshaneh Goodarzi
Neonatal jaundice is the most common cause of hospitalization of term and preterm infants. Although this situation is generally benign, all the jaundices in the first 24 hours of birth are pathologic. High levels of non-conjugated bilirubin can cause nerve damage and create kernicterus. Considering the possibility of preventing the complications of this disease by early diagnosis of the cause of jaundice and proper treatment, and given the limited studies on the epidemiological causes of jaundice in the first 24 hours of birth, we decided to do this study. In this retrospective cross-sectional study, all newborns with jaundice in the first 24 hours of birth who were admitted to Children's Hospital and Shariati Hospital of Bandar Abbas in 2010-2014 were included. Criteria for inclusion in the study; the onset of jaundice under 24 hours and clinical diagnosis of jaundice by neonatologist and exclusion criteria included; severe chromosomal abnormalities and inadequate case records. All cases were examined using census-based method. The data was collected by a researcher-made checklist and then was entered into the SPSS statistical program version 20. It was analyzed by descriptive statistical methods. In this study, 378 cases were investigated and finally, 57 cases were excluded due to incomplete records. Of the 321 neonates, 174 were boys (54.2%) and 147 were girls (45.8%), 237 were terms (73.8%) and 84 were pre-term (26.2%). 172 cases were born by natural delivery (53.6%) and 149 cases by cesarean section (46.4%). 51 (15.9%) of mothers had gestational diabetes mellitus. 309 (96.3%) were born with Apgar more than or equal to 6. The total mean of hemoglobin was 15.20±2.67 mg/dl. The mean bilirubin level was 13.26±4.41 mg/dl, with a minimum of 5.5 and a maximum of 28. For 35 infants, blood transfusion was performed. In all cases, increased non-conjugated bilirubin was observed, except for one case that was suspected to have Down syndrome. 20 cases (6.2%) had RH incompatibility, 124 cases (36.6%) had ABO incompatibility, 99 cases (30.8%) had G6PD deficiency, and 5 (1.6%) had ABO and Rh incompatibilities simultaneously. 27 (8.4%) simultaneously had ABO incompatibility and G6PD deficiency. 5 (1.6%) simultaneously had RH incompatibility and G6PD deficiencies. 4 (1.2%) had concurrent RH and ABO incompatibilities and G6PD deficiency. The results of this study showed that the most common cause of jaundice on the first day in neonates was ABO incompatibility. Also, the highest amount of jaundice on the first day was for male, term, and normal birth weight babies. Most of these cases were born in a natural delivery. The results of this study are consistent with most similar studies.