Neonatal Jaundice Risk Factors at a District Hospital in Rwanda

Murekatete, Claudine; Muteteli, Claudine; Nsengiyumva, Richard; Chironda, Geldine

doi:10.4314/rjmhs.v3i2.10

“…However, it absolutely was beyond a nding from Pakistan (27.6%) [11], Benin (26.5%) [21] and Ghana (32.9%) [32]. It was also quite higher as compared to nding from Nepal [18], Indonesia (4.08%) [33], Iran (12.6%) [34], Congo (7.2%) [35], Uganda (22.7%) [36] and Saint Paul's millennium medical college of Ethiopia (13.3%) [27].This nding was concordant with a previous study conducted in Iran (44.8%) [37], Southeast Nigeria (35%) [38], Rwanda (44.3%) [22], and Black lion Ethiopia [39]. This disparity could be due to sampling size, study period difference, study design, study area, methodology difference, and coverage of obstetrics care, de nitions of hyperbilirubinemia, and characteristics of the study participant.…”

Section: Discussionsupporting

confidence: 87%

“…There is a multiplicity of risk factors associated with maternal, prenatal, and neonatal factors related to the occurrence of neonatal hyperbilirubinemia that can be modi able and manageable [14][15][16][17][18][19][20][21]. In Nigeria, neonatal sepsis, prematurity, and G-6PD de ciency are factors signi cantly associated with neonatal hyperbilirubinemia [21] while in Rwanda, birth weight, gestational age, neonatal gender, method of delivery, blood group incompatibility, infections, cesarean section, and prematurity are signi cantly associated with neonatal hyperbilirubinemia [22].…”

Section: Introductionmentioning

confidence: 99%

Hyperbilirubinemia and associated factors among neonates admitted to neonatal care unit in Jimma Medical Center

Asaye¹,

Bekele²,

Getachew³

et al. 2022

Preprint

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Background: Neonatal hyperbilirubinemia is a widespread and significant clinical problem among neonates worldwide. Globally, every year about 1.1 million babies develop it and the vast majority reside in South Asia and sub-Saharan Africa. Studies on magnitude and factors associated with neonatal hyperbilirubinemia are limited in Ethiopia. So this study was aimed at assessing the prevalence and associated factors of neonatal hyperbilirubinemia among hospitalized neonates in the neonatal intensive care unit of Jimma Medical Center (JMC), Jimma, South West Ethiopia. Methods: Hospital-based cross-sectional study was conducted at JMC from July 24 to October 19, 2020. A total of two hundred twenty-two neonates with their mothers were included and conveniently selected. Data was collected by interviewing mothers through structured questionnaires and reviewing neonates' medical records using a checklist. Multivariable binary logistic regression analyses were employed to identify factors associated with neonatal hyperbilirubinemia. Results: from a total of neo-maternal pairs included in the studies; the proportion of Neonatal hyperbilirubinemia was found to be 94(42.3%). Neo-maternal ABO incompatibility 33 (35.1%), prematurity41 (43.6%), sepsis 35 (37.2%), Neonatal birth asphyxia 20 (21.2%), and Rh isoimmunization 10 (10.6%) was significantly associated with neonatal hyperbilirubinemia.Conclusion and Recommendations: The prevalence of neonatal hyperbilirubinemia in the study setting was high. Antenatal care (including both mother and fetus detail examination and follow-ups) as well cautions during labor need to focus since Neonatal hyperbilirubinemia-associated factors were maternal and neonatal. Hence, further assessment, early intervention, and timely treatment are important to mitigate the burdens in neonates due to hyperbilirubinemia.

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“…In this work, the CD accounts for 48.60 and 56.52% of Xiangxi and NICU newborns, which were higher than the Chinese average in 2018 (36.7%) (33,35). The characteristics of pregnancy and newborn in advanced maternal age (36), high CD rates (37), and premature infants (28,29) increased the prevalence of jaundice. In conclusion, pregnancy characteristics were associated with the occurrence of newborn diseases, which required more attention and in-depth exploration.…”

Section: Discussionmentioning

confidence: 59%

The Disease Spectrum and Influencing Factors of NICU in Xiangxi, Underdeveloped Area of China: A 9-Year Retrospective Study

Xie

¹

,

Zhu

²

,

Chen

³

et al. 2022

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ObjectiveInvestigation of the basic conditions and disease spectrum in neonatal intensive care unit (NICU) from 2012 to 2020, in the underdeveloped area of Xiangxi, China.MethodsAll newborns (N = 16,094) admitted to the NICU of a hospital in the Xiangxi area from 2012 to 2020 were selected for the retrospective study.ResultsThe average male/female ratio was 1.43:1, with 9,482 males and 6,612 females admitted to the NICU. The sample comprised 41.02% premature infants, and 56.52% had been delivered via cesarean delivery (CD). The most prevalent diseases diagnosed in the NICU were jaundice (22.01%), respiratory (18.45%) and neurological diseases (17.54%). Over the 9-year study window, the prevalence of jaundice and cardiovascular diseases increased, while respiratory and neurological diseases became less frequent. The prevalence of the remaining diseases remained unchanged. Prevalence of neonatal diseases is influenced by gender, patient sources, delivery methods, gestational age and birth weight (P < 0.05). The prevalence of neonatal diseases was significantly higher in males, infants born via CD, and in infants of lower gestational age and birth weight.ConclusionThe study contributes in-depth information about infant characteristics in an NICU in an undeveloped region of China. In the past 9 years, the average proportion of premature infants in the NICU decreased to 37.38% in 2020, but this figure remains higher than the Chinese national average of 26.2%. Similarly, the CD rate is higher than the Chinese average. The spectrum of neonatal diseases in the NICU in Xiangxi area is drawn, included jaundice, respiratory and neurological diseases, primarily. Through statistical analysis, it is found that the types and prevalence of neonatal diseases are closely related to different gender, gestational age, patient sources, delivery methods, and birth weight (P < 0.05). Newborns of specific gestational age, birth weight and delivery method should be considered “at-risk” and targeted in the formulation of preventive measures. There is a great need to improve the diagnosis and treatment of neonatal diseases—and perinatal health care in general—to ensure improved outcomes for newborns admitted to NICUs in underdeveloped regions.

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“…Two cross-sectional studies from Iran considered the age extremes, less than 18 and more than 35 years, as a risk factor [17,18]. Moreover, Murekatete et al reported that the majority of mothers with infants diagnosed with neonatal indirect hyperbilirubinemia were aged between 25 years and 35 years in Rwanda District Hospital [19].…”

Section: International Journal Of Pediatricsmentioning

confidence: 99%

Neonatal and Maternal Risk Factors for Indirect Hyperbilirubinemia: A Cross-Sectional Study from Bahrain

Isa

¹

,

AlBuainain

²

,

Bunajem

³

et al. 2022

International Journal of Pediatrics

1

0

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Background and Objectives. Jaundice is a common cause of hospital admission in infants presenting within the first month of life. This study is aimed at determining neonatal and maternal risk factors of indirect hyperbilirubinemia, at comparing neonates with risk factors and those without, and at assessing the type of management according to hyperbilirubinemia severity. Material and Methods. In this retrospective cross-sectional study, medical records of neonates with indirect hyperbilirubinemia who were admitted to the Pediatric Department, Salmaniya Medical Complex, Bahrain, between January 2020 and December 2020 were reviewed. Neonatal demographic data, antenatal history, birth weight, feeding type, maternal and neonatal laboratory evaluations, management, and length of hospital stay were collected and compared. Results. Out of 555 records, 404 neonates were included. Among those, 209 (51%) were males and 275 (68.1%) were Bahraini. The median indirect bilirubin level at presentation was 218 (interquartile range, 174-270) μmol/L. ABO incompatibility was the commonest risk factor for neonatal indirect hyperbilirubinemia ( n = 152 , 37.6%) followed by glucose-6-phosphate dehydrogenase (G6PD) deficiency ( n = 130 /400, 32.5%). Age (>25 years) was the commonest maternal risk factor ( n = 331 , 81.9%) followed by cesarean delivery ( n = 137 , 33.9%). Neonates with ABO incompatibility had a significantly higher mean indirect bilirubin level compared to those with other risk factors ( 234.9 ± 68.5 versus 225 ± 82.2 mmol/L, respectively) ( P = 0.04 ). Phototherapy use significantly increased along with the rise of bilirubin level ( P < 0.0001 ). Intravenous immunoglobulins (IVIG) and exchange transfusion were used in 44 (10.9%) and 14 (3.5%) patients, respectively. Neonates who received IVIG had significantly higher bilirubin levels than those who did not ( P = 0.005 ). Male newborns ( P = 0.008 ), Bahrainis ( P = 0.001 ), those with reticulocytosis ( P = 0.001 ), and those who received IVIG ( P = 0.001 ) were more prone to have associated risk factors. Conclusion. ABO incompatibility, G6PD deficiency, and older maternal age were the commonest neonatal and maternal risk factors for developing neonatal indirect hyperbilirubinemia. Bahraini, male newborns, reticulocytosis, and IVIG use were associated with these factors. Early detection of such factors through screening can aid in immediate management to prevent serious complications of this common condition.

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Neonatal Jaundice Risk Factors at a District Hospital in Rwanda

Cited by 9 publications

References 13 publications

Hyperbilirubinemia and associated factors among neonates admitted to neonatal care unit in Jimma Medical Center

Hyperbilirubinemia and associated factors among neonates admitted to neonatal care unit in Jimma Medical Center

The Disease Spectrum and Influencing Factors of NICU in Xiangxi, Underdeveloped Area of China: A 9-Year Retrospective Study

Neonatal and Maternal Risk Factors for Indirect Hyperbilirubinemia: A Cross-Sectional Study from Bahrain

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