Jaundice among Hospitalized Newborn Infants in Sagamu: Observations on Aetiology and Clinical Course.

Abstract

Abstract background: Neonatal jaundice may be caused by physiological events and/or as specific disease conditions, while the clinical course may be related to the aetiology.

Objective: To determine the spectrum of identifiable causes as well as the clinical course of jaundice among hospitalized babies.

Methods: Babies hospitalized with jaundice requiring therapy in a tertiary hospital were prospectively studied for the aetiology and the pattern of total serum bilirubin (TSB). Babies with unexplained jaundice were compared with babies in whom the aetiology was known.

Results: Jaundice was unexplained in 51 (20.6 percent) of 248 babies aged 0 to 240 hours, while 50 (20.2 percent) had various combinations of prematurity, blood group incompatibilities, Glucose-6-phosphate dehydrogenase (G6PD) deficiency and septicaemia. Babies with G6PD deficiency had the highest mean peak TSB (26.3 + 9.0mg/dl), those with Rhesus incompatibility had their peak TSB earliest (5.7 + 0.8 days), while the mean duration of phototherapy was longest in babies whose jaundice was due to prematurity (10.4 + 0.9 days). Exchange blood transfusion (EBT) rate was highest among babies with Rhesus incompatibility (100.0 percent) and G6PD deficiency (70.3 percent). Preterm infants tended to have multiple EBT sessions compared to term infants (p < 0.001). Bilirubin encephalopathy was most frequent among babies with G6PD deficiency (62.1 percent).

Conclusion: There appears to be a pattern of clinical events which are peculiar to the specific aetiology of newborn jaundice.

Keywords: Exchange transfusion, Hyperbilirubinaemia, Newborn, Serum bilirubin