Abstract
Background: Neonatal jaundice is a common condition especially in the first week of life. There are various maternal and neonatal clinical characteristics that have been associated with pathological jaundice. Objectives: To describe clinical profile of pathological jaundice and to estimate its prevalence among newborns admitted at the National Referral Hospital. Methods: A cross-sectional descriptive study design was used to study pathological jaundice cases admitted at the Gyaltsuen Jetsun Pema Neonatal Intensive Care Unit (NICU) of Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) from 7th November 2018 till 6th November 2019. Data was collected using a predesigned case proforma, entered and analyzed in Epidata after obtaining ethical clearance from the Research Ethics Board of Health (REBH), Bhutan. Results: Facility based prevalence rate of pathological neonatal jaundice was found to be 63.66% in our setting. The median age on presentation was 4 days. Blood group ABO incompatibility and neonates less than one week of age were found to be most common neonatal profile in this study. Significant association was found between primiparous mothers and excessive weight loss. Conclusion: The prevalence of pathological jaundice was high in our setting. ABO incompatibility, neonates less than one week of age, primigravida mothers with feeding issues should be closely followed or screened for pathological jaundice especially during the first one week of life.
 Keywords: Pathological jaundice, Prevalence, ABO incompatibility, feeding issues, excessive weight loss
Highlights
This study provides a baseline data on clinical profile and prevalence of pathological jaundice in the National Referral Hospital
Our study showed an association between primiparous mothers and excessive weight loss in neonates compared with multiparous mothers which was highly significant (p-value of 0.016)
The most common clinical profile of neonates with pathological jaundice observed in our study were ABO incompatibility, primiparous mothers with feeding issues and neonates less than one week of age
Summary
We aimed to describe the clinical profile of pathological jaundice and to estimate its prevalence among newborns admitted at the National Referral Hospital of Bhutan. Conclusions: ABO incompatibility, neonates less than one week of age, primiparous mothers with feeding issues should be closely followed or screened for pathological jaundice especially during the first one week of life. Neonatal jaundice is a very common condition worldwide occurring in up to 60% of term and 80% of preterm newborns[1]. It is one of the main reasons for neonatal admissions and morbidity especially during the first week of life. The elevated bilirubin in newborns is due to the immature hepatic metabolism of bilirubin, the increased red blood cell turnover, and the shorter lifespan of red blood cells.
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