Severe neonatal hyperbilirubinemia in the southeast region of Turkey

Özlem Çetinkaya Bozkurt ,Ömür Akinel,Berna Oguz ,Mehmet Fatih Palali,Erdinç Yücesoy ,Nuh Atas

doi:10.3906/sag-1906-22

Özlem Çetinkaya Bozkurt , Ömür Akinel + Show 4 more

Open Access

https://doi.org/10.3906/sag-1906-22

Copy DOI

Abstract

Severe neonatal hyperbilirubinemia is an important cause of morbidity and mortality in developing countries. The aim was to assess etiologic reasons for development of severe hyperbilirubinemia and define risk factors for exchange transfusion and acute bilirubin encephalopathy (ABE) in Şanlıurfa located in the southeast region of Turkey. An observational cohort study included 115 infants with ≥35 weeks of gestation admitted with diagnosis of severe hyperbilirubinemia in a period of 18 months. Potential risk factors associated with exchange transfusion and development of ABE were analyzed. Among 115 infants, 67 (58.3%) received exchange transfusion and 45 (39.1%) developed ABE. Rh isoimmunization (OR: 24.6, 95% CI = 2.2–271, P = 0.009), glucose-6-phosphate dehydrogenase deficiency (G6PD) (OR: 21.1, 95% CI = 1.8–238.4, P = 0.01), early discharge (OR: 14.4, 95% CI = 4.2–48.9, P ≤ 0.001), and male sex (OR: 4.3, 95% CI = 1.3–14.1, P = 0.02) were independently associated with an increased risk for exchange transfusion. Being a refugee (OR: 6.8, 95% CI = 1.8–25.8, P = 0.005) and G6PD deficiency (OR: 9.9, 95% CI = 1.3–71.9, P = 0.02) were associated with development of ABE. Early discharge, Rh isoimmunization, and G6PD deficiency are significant risk factors for severe hyperbilirubinemia and exchange transfusion. Prevention of early hospital discharges, family education to increase awareness for hazardous effects of hyperbilirubinemia, and early follow-up visits after discharge would reduce the disease burden.

Highlights

Neonatal jaundice is usually a physiologic condition and is one of the most common causes of hospital admissions in otherwise healthy newborns [1,2]
Rh isoimmunization (OR: 24.6, 95% confidence interval (CI) = 2.2–271, P = 0.009), glucose-6-phosphate dehydrogenase deficiency (G6PD) (OR: 21.1, 95% CI = 1.8–238.4, P = 0.01), early discharge (OR: 14.4, 95% CI = 4.2–48.9, P ≤ 0.001), and male sex (OR: 4.3, 95% CI = 1.3–14.1, P = 0.02) were independently associated with an increased risk for exchange transfusion
Being a refugee (OR: 6.8, 95% CI = 1.8–25.8, P = 0.005) and G6PD deficiency (OR: 9.9, 95% CI = 1.3–71.9, P = 0.02) were associated with development of acute bilirubin encephalopathy (ABE)

Summary

Introduction

Neonatal jaundice is usually a physiologic condition and is one of the most common causes of hospital admissions in otherwise healthy newborns [1,2]. With implementation of standardized and harmonized guidelines for management of hyperbilirubinemia, the incidence of severe hyperbilirubinemia has decreased markedly in high income countries (HICs) [1,7,8,9,10,11]. It is still an important problem resulting in significant disability and mortality in low and middle income countries (LMICs) [12,13,14,15]. Şanlıurfa, located in the southeast region of Turkey, has the highest birth rate in Turkey with 4.29 children per year. it is one of the cities harboring the highest Syrian refugee population, composing 23.6% of its population.

Objectives

Methods

Results

Conclusion