References
Maternal and neonatal factors associated with neonatal jaundice in Jordan: a case-control study
Abstract
Background/Aims
Neonatal jaundice is a common cause of hospitalisation. This study aimed to identify maternal and neonatal factors associated with neonatal jaundice among hospitalised neonates in north Jordan.
Methods
This was a case control study involving 312 mothers and their neonates (106 cases, 206 controls), recruited from two governmental hospitals in north Jordan. A structured interview was used to collect data. Neonatal medical records were accessed for clinical data.
Results
Maternal factors associated with higher risk of jaundice included having higher education, being employed and having had a caesarean section. Neonatal factors associated with higher risk of jaundice included being preterm, receiving <5 feeds per day and having ABO incompatibility.
Conclusions
Using evidence-based guidelines for the assessment and management of risk factors helps to reduce the prevalence of jaundice requiring hospitalisation among neonates. Raising mothers' awareness of neonatal jaundice through interventions and education sessions during antenatal care, in particular for high-risk mothers, is also likely to help reduce its prevalence.
Neonatal jaundice is a common cause of hospitalisation for both full-term and preterm neonates (Mojtahedil et al, 2018). Almost all newborns have a total serum bilirubin level of >1mg/dL, the upper limit of normal for adults (Aynalem et al, 2020). High levels (≥5mg/dL) manifest clinically as jaundice and, a consequence of increased breakdown of red blood cells and/or decreased hepatic excretion of bilirubin, producing a yellow-orange discoloration of the skin and sclera (Brits et al, 2018; Olatubi et al, 2019). Neonatal jaundice commonly occurs in the first week after birth, although it is not harmful, is self-limiting and usually improves without treatment (Awang et al, 2020; Ricci et al, 2021).
Factors associated with the development of neonatal jaundice include prematurity, ABO incompatibility, Rh incompatibility, glucose-6-phosphate dehydrogenase (G6PD), sepsis, breast problems (eg sore or cracked nipples or breast engorgement, associated with inadequate intake of breast milk), breastfeeding patterns, prolonged labor, having siblings who had neonatal jaundice, high birth weight, primiparity, male gender, mode of birth and maternal diabetes mellitus (Olatubi et al, 2019; Seyedi et al, 2019; Abbas et al, 2020; Aynalem et al, 2020; Boskabadi et al, 2020; West and Josiah, 2020; Bogale et al, 2021; Karasneh et al, 2021; Wongnate, 2021). Acute bilirubin encephalopathy (kernicterus) is a major complications of hyperbilirubinemia, which can cause a spectrum of neurologic problems (Aynalem et al, 2020). Surviving neonates may have long-term neurodevelopmental deficits, such as cerebral palsy, sensorineural hearing loss, intellectual difficulties and gross developmental delays (Aynalem et al, 2020).
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