Clinico-Investigative Profile of Prolonged Hyperbilirubinemia in Newborns Presenting to Tertiary Health-Care Setup in Rural Maharashtra

Abstract

Introduction

Prolonged hyperbilirubinemia is defined as high bilirubin levels (>10 mg/dL) persisting beyond day 14 of life in term neonates and beyond day 21 in preterm neonates.

Methods and Material

A prospective cross-sectional study was conducted at a rural tertiary care hospital after obtaining an ethical approval and an informed consent. All infants under 6 months of age with hyperbilirubinemia after 21 days in preterm and 14 days in term were included. This study was designed to determine the proportion of prolonged hyperbilirubinemia and its causes and investigative profile in rural tertiary care.

Results

Out of total infants showing hyperbilirubinemia, 30.51% of patients had conjugated hyperbilirubinemia with female predominance, whereas 69.49% had unconjugated hyperbilirubinemia with male predominance. In our study, 38.14% were diagnosed with breast milk jaundice, followed by 33.90% caused by septicemia and 10.17% cases of cephalhematoma. In addition, hypothyroidism and TORCH infections were observed in 4.24% of cases, whereas a single case of cystic hygroma, subdural emphysema, pyloric stenosis, and G6PD deficiency was seen. In comparison, late-onset hemorrhagic disease of newborns was observed in 3.39% of cases.

Conclusion

Breast milk jaundice was the most frequently encountered etiologies of prolonged hyperbilirubinemia and hence, unnecessary investigation for unconjugated hyperbilirubinemia should be avoided.