Study Of The Incidence And Predictors Of Neonatal Hyperbilirubinemia In Shebeen El Koom Teaching Hospital:

Shaimaa Mohammed Azab Ahmed

The high incidence of neonatal jaundice combined with theshortening of post natal stay at hospital make the early screening andsurveillance for neonatal hyperbilirubinemia essential to ensure that theseinfants are not missed, as it is still not known at what level bilirubin cancause a significant risk of brain damage.So before discharge, every newborn infant should be assessed forthe risk of hyperbilirubinemia. The predischarge bilirubin measurementsusing TSB or TCB and/or assessment of clinical risk factors are used asscreening tools for predicting the neonatal hyperbilirubinemia.This study aimed at detecting the incidence of neonatalhyperbilirubinemia at Shebeen Elkoom teaching hospital among theperiod from January, 2007 through June, 2007, predicting the neonataljaundice by using the both clinical scoring system and TCBmeasurements and finally performing a correlation between TCB andTSB.Our study included 230 neonates, of them 72 cases (31.3%)developed hyperbilirubinemia.There was a statistically significant increase in the incidence ofneonatal hyperbilirubinemia in babies whose mothers had hypertension,pre eclampsia, diabetes mellitus, obstructed labor and mothers withprevious jaundiced baby. While there was no statistically significantincrease in the incidence of neonatal hyperbilirubinemia in babies whosemothers had vaginal bleeding, prolonged rupture of membranes, oxytocinuse and mothers delivered by CS.Summary & Conclusion--There was a statistically significant increase in the incidence ofneonatal hyperbilirubinemia in babies with cephalohematoma, prematuredelivery, those with SGA, those with combined breast and bottle feedingand male infants. There was no statistically significant increase in theincidence of neonatal hyperbilirubinemia among the babies withexclusive breastfeeding.There was a very strong positive correlation between TSB andTCB with (r=0.997).A clinical risk scoring also was suggested for detection of neonatalhyperbilirubinemia but we found that there is a priority for usingpredischarge TCB rather than the clinical scoring system in prediction ofneonatal hyperbilirubinemia.from the above results it is concluded that:-1- Every newborn should be assessed for the risks of developingsever hyperbilirubinemia postnattaly.2- Early prediction of neonatal hyperbilirubinemia by predischargeTCB or TSB and/or assessment of clinical risk factors areimportant to avoid the hazards of sever hyperbilirubinemia andits threat of brain damage.3- The predischarge bilirubin measurement is more accurate andgenerates wider risk stratification than a clinical risk factor.4- TCB measurements had demonstrated a strong positive linearcorrelation with TSB.5- Exclusive breastfeeding decrease the incidence of neonataljaundice compared to bottle feeding, but if these infants arestarved or dehydrated, they could probably be at higher risk ofbilirubin encephalopathy.6- There is no effect of oxytocin used for labor induction in theincidence of neonatal jaundice.