The risk factors for unconjugated hyperbilirubinemia and readmission jaundice in intramural neonates ≥35 weeks

Abstract

Background: Neonatal hyperbilirubinemia is a common condition that is typically benign, although in some cases it may progress to kernicterus. Because neonatal jaundice is both preventable and treatable when detected early, identifying risk factors for developing severe hyperbilirubinemia is essential. Materials and Methods: A prospective observational study was conducted to examine the risk factors associated with significant neonatal jaundice and hospital readmission for jaundice. Results: A total of 600 neonates were enrolled. Among them, 15% (n = 90) developed significant jaundice prior to discharge, and 2.5% (n = 15) required readmission. Maternal risk factors for significant jaundice included primigravida status with maternal age between 23 and 27 years, blood group O, conception by in vitro fertilization and embryo transfer (IVF–ET), antenatal oxytocin use, and lower-segment cesarean section. Neonatal risk factors included late-preterm male infants with birth weight between 2 and 2.5 kg and delayed cord clamping (DCC). Maternal risk factors for readmission included young primigravida women with blood group O from North India, antenatal oxytocin use, and gestational diabetes mellitus. Neonatal risk factors for readmission included low birth weight, DCC, twin pregnancy, and discharge between 48 and 72 hours after birth. Conclusion: The statistically significant factors (P<0.05) associated with an increased risk of developing significant hyperbilirubinemia requiring readmission were low birth weight, gestational age of 35–36⁶⁄₇ weeks, DCC, and conception via IVF–ET.