WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

*Dr. Sarmad Osamah Rashid Alfil, Dr. Raghad Taha Aziz, Dr. Zakaria Abdul Khaliq Kassim

ABSTRACT

Background: Neonatal jaundice is one of the most prevalent clinical disorders encountered during the neonatal period, accounting for a significant proportion of neonatal hospital admissions globally. Objectives: To identify the causes, risk factors, and complications of newborn jaundice among neonates admitted to Al-Khansaa Teaching Hospital. Methods: This one-year cross-sectional study was carried out in the neonatal unit of Al-Khansaa Teaching Hospital in Mosul, Iraq, from January 2024 to December 2024. All newborns aged 28 days or younger who were admitted with clinical jaundice during the study period were eligible to participate. Results: The study includes 420 neonates with jaundice. The mean age at presentation was 3.9 ± 1.6 days and 96 neonates (22.9%) had a birth weight of less than 2500 gram. Moreover, 236 (56.2%) were males and 184 (43.8%) were females. With male to female ratio of 1.282:1. Term neonate accounted for 302 cases (71.9%), while 118 neonates (28.1%) were preterm. Physiological jaundice was the most frequent diagnosis, accounting for 262 cases (62.4%), while pathological jaundice was reported in 158 infants (37.6%). Pathological jaundice was significantly more prevalent in preterm infants than in term neonates (P value <0.001). In terms of severity, 262 neonates (62.4%) had mild to moderate hyperbilirubinemia (<15 mg/dL), while 158 had severe hyperbilirubinemia (>15 mg/dL). Severe hyperbilirubinemia has been associated to pathological causes of jaundice (P value < 0.001). ABO incompatibility was the commonest cause of pathological jaundice, found in 45 (28.5%) patients followed by G6PD deficiency in 37 (23.4%) patients, neonatal sepsis in 32 (20.3%) patients, prematurity-related jaundice in 24 (15.2%) patients, Rh incompatibility in 12 (7.6%) patients and cephalhematoma in 8 (5%) patients. Neonatal jaundice complications occurred in 22 (5.2%) patients. 15 (3.6%) patients required an exchange transfusion, while 7 (1.6%) patients suffered kernicterus. The two complications were significantly more common among patients with hemolytic causes and severe hyperbilirubinemia (P value < 0.001). Lastly, neonates who have mothers with gestational diabetes mellitus was significant have higher pathological jaundice (P value = 0.035). Of note, other variables (blood group O, Rh negative and previous neonatal jaundice was trend to be significant). Conclusion: Pathological newborn jaundice accounted for a significant proportion of cases and was significantly linked to preterm, hemolytic causes (especially ABO incompatibility and G6PD deficiency), severe hyperbilirubinemia, and maternal gestational diabetes. Severe cases were associated with sequelae such as exchange transfusions and kernicterus, emphasizing the persistent clinical burden of preventable bilirubin neurotoxicity.

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