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      Determinants of neonatal jaundice among neonates admitted to neonatal intensive care unit in public hospitals of Sidama Region, Sidama, Ethiopia, 2022: an unmatched case-control study

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          Abstract

          Introduction

          neonatal jaundice appears in most neonates as “physiological jaundice” in the first few weeks of life; however, pathological jaundice is associated with an increased risk of long-term complications and mortality only a few studies have been conducted on the determinants of neonatal jaundice in Ethiopia. The aim of this study was to identify the determinants of neonatal jaundice (pathological) among neonates admitted to neonatal intensive care units in Sidama Region general and referral public hospitals.

          Methods

          a hospital-based unmatched case-control study was conducted among 270 neonates in public hospitals of Sidama Region from June 23 to August 8, 2022. We used a pre-tested interviewer-administered questionnaire and collected by open data kit (ODK) then the data was downloaded and exported to Microsoft Excel worksheets (XLS) and imported to SPSS version 26 for further analysis. Bi-variable logistic regression analysis was performed. Variables with a P-Value of less than 0.25 were included in multivariable logistic regression. Multi-variable logistic regression was performed and Adjusted Odds ratio (AOR) with a 95% confidence interval was computed and statistical significance was declared at a p-value <0.05.

          Results

          a total of 270 neonates with mothers (90 cases and 180 controls) with a response rate of 100% were included in this study. Factors significantly increased the odds of developing neonatal jaundice were multiparty (AOR=2.869(95%CI 1.426-5.769)), prolonged duration of labor (AOR=4.618(95%CI 1.689 - 12.625)). ABO incompatibility (AOR=3.362(95%CI, 1.185 - 9.537)). Preterm (AOR=2.936(95%CI, 1.2456.923)), birthasphyxia (AOR=2.278(95%CI,1.1454.531)) and polycythemia (AOR=3.397(95%CI, 1.147-10.061)).

          Conclusion

          in this study multiparty, prolonged duration labor, ABO incompatibility, preterm gestational age, birth asphyxia, and polycythemia were factors that significantly increased the odds of developing neonatal jaundice.

          Most cited references29

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          Neonatal hyperbilirubinaemia: a global perspective

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            Neonatal hyperbilirubinemia and Rhesus disease of the newborn: incidence and impairment estimates for 2010 at regional and global levels

            Background: Rhesus (Rh) disease and extreme hyperbilirubinemia (EHB) result in neonatal mortality and long-term neurodevelopmental impairment, yet there are no estimates of their burden. Methods: Systematic reviews and meta-analyses were undertaken of national prevalence, mortality, and kernicterus due to Rh disease and EHB. We applied a compartmental model to estimate neonatal survivors and impairment cases for 2010. Results: Twenty-four million (18% of 134 million live births ≥32 wk gestational age from 184 countries; uncertainty range: 23–26 million) were at risk for neonatal hyperbilirubinemia-related adverse outcomes. Of these, 480,700 (0.36%) had either Rh disease (373,300; uncertainty range: 271,800–477,500) or developed EHB from other causes (107,400; uncertainty range: 57,000–131,000), with a 24% risk for death (114,100; uncertainty range: 59,700–172,000), 13% for kernicterus (75,400), and 11% for stillbirths. Three-quarters of mortality occurred in sub-Saharan Africa and South Asia. Kernicterus with Rh disease ranged from 38, 28, 28, and 25/100,000 live births for Eastern Europe/Central Asian, sub-Saharan African, South Asian, and Latin American regions, respectively. More than 83% of survivors with kernicterus had one or more impairments. Conclusion: Failure to prevent Rh sensitization and manage neonatal hyperbilirubinemia results in 114,100 avoidable neonatal deaths and many children grow up with disabilities. Proven solutions remain underused, especially in low-income countries.
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              Burden of severe neonatal jaundice: a systematic review and meta-analysis

              Context To assess the global burden of late and/or poor management of severe neonatal jaundice (SNJ), a common problem worldwide, which may result in death or irreversible brain damage with disabilities in survivors. Population-based data establishing the global burden of SNJ has not been previously reported. Objective Determine the burden of SNJ in all WHO regions, as defined by clinical jaundice associated with clinical outcomes including acute bilirubin encephalopathy/kernicterus and/or exchange transfusion (ET) and/or jaundice-related death. Data sources PubMed, Scopus and other health databases were searched, without language restrictions, from 1990 to 2017 for studies reporting the incidence of SNJ. Study selection/data extraction Stratification was performed for WHO regions and results were pooled using random effects model and meta-regression. Results Of 416 articles including at least one marker of SNJ, only 21 reported estimates from population-based studies, with 76% (16/21) of them conducted in high-income countries. The African region has the highest incidence of SNJ per 10 000 live births at 667.8 (95% CI 603.4 to 738.5), followed by Southeast Asian, Eastern Mediterranean, Western Pacific, Americas and European regions at 251.3 (132.0 to 473.2), 165.7 (114.6 to 238.9), 9.4 (0.1 to 755.9), 4.4 (1.8 to 10.5) and 3.7 (1.7 to 8.0), respectively. The incidence of ET per 10 000 live births was significantly higher for Africa and Southeast Asian regions at 186.5 (153.2 to 226.8) and 107.1 (102.0 to 112.5) and lower in Eastern Mediterranean (17.8 (5.7 to 54.9)), Americas (0.38 (0.21 to 0.67)), European (0.35 (0.20 to 0.60)) and Western Pacific regions (0.19 (0.12 to 0.31). Only 2 studies provided estimates of clear jaundice-related deaths in infants with significant jaundice [UK (2.8%) and India (30.8%). Conclusions Limited but compelling evidence demonstrates that SNJ is associated with a significant health burden especially in low-income and middle-income countries.
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                Author and article information

                Contributors
                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                06 July 2023
                2023
                : 45
                : 117
                Affiliations
                [1 ]Department of Midwifery, Hawassa University, Hawassa, Sidama, Ethiopia,
                [2 ]Department of Midwifery, Jimma University, Jimma, Oromia, Ethiopia,
                [3 ]Department of Epidemiology and Biostatistics, School of Public Health, Wolayita Sodo University, Sodo, Ethiopia
                Author notes
                [& ] Corresponding author: Biniyam Demessie Sisay, Department of Midwifery, Hawassa University, Hawassa, Sidama, Ethiopia. demissiebiniam41@ 123456gmail.com
                Article
                PAMJ-45-117
                10.11604/pamj.2023.45.117.40472
                10516761
                37745917
                fa2fc47a-e288-45bc-8cff-767c9352ffc5
                Copyright: Biniyam Demessie Sisay et al.

                The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 18 May 2023
                : 29 June 2023
                Categories
                Research

                Medicine
                neonatal jaundice,determinants,case-control study,sidama region,public,hospitals
                Medicine
                neonatal jaundice, determinants, case-control study, sidama region, public, hospitals

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