Study of some factors associated with prolonged neonatal jaundice

Abstract

Objective The aim was to study some factors associated with prolonged neonatal jaundice and to find out the important investigations that should be performed to such cases. Background Prolonged neonatal jaundice represents a dilemma for many doctors. Many factors are responsible for its occurrence. Patients and methods This is a cross-sectional study on 55 cases of prolonged neonatal jaundice, conducted from Menoufia and Benha university hospitals from November 2017 to July 2018. All cases were subjected to history taking, clinical assessment, and investigations including complete blood count, c-reactive protein, total and direct serum bilirubin, blood group and RH factor for the cases and their mothers and urine analysis. We investigated cases with prolonged direct hyperbilirubinemia for alanine aminotransferase, aspartate aminotransferase and abdominal ultrasonography. Results Cases aged ranged from 14 to 49 days of life, with mean age '19.3 ± 5.3' that included nine preterm and 46 full term. Prolonged indirect neonatal hyperbilirubinemia was found in 85% of cases, while 15% had direct hyperbilirubinemia. All cases showed normal complete blood count. C-reactive protein is negative in all cases. Breast-milk jaundice was found in 32.7%, ABO incompatibility in 22%, while RH incompatibility in only 3.6% of cases. Pyuria greater than or equal to 6 pus cells/ High power field (HPF) was found in 20% of cases and they had higher serum bilirubin than the other cases without pyuria. Conclusion The most common associated factor was breast-milk jaundice, then ABO incompatibility and then pyuria. Blood group identification to the mother and their neonates and urine analysis have a great diagnostic value in these cases. Larger studies are needed to confirm these findings.