Severe neonatal hyperbilirubinemia in the south-east region of Turkey.

Abstract

BACKGROUND/AIM\nSevere neonatal hyperbilirubinemia, is an important cause of morbidity and mortality in developing countries. The aim was to assess etiologic reasons for development of severe hyperbilirubinemia and to define risk factors for exchange transfusion and acute bilirubin encephalopathy (ABE) in Sanliurfa located in south-east region of Turkey.\n\n\nMATERIALS AND METHODS\nAn observational cohort study included 115 infants with ? 35 weeks? gestation admitted with diagnosis of severe hyperbilirubinemia in a period of 18 months. Potential risk factors associated with exchange transfusion and development of ABE were analyzed.\n\n\nRESULTS\nOf the 115 infants, 67 (58.3%) received exchange transfusion and 45 (39.1%) developed ABE. Rh isoimmunization (OR: 24.6, 95% CI = 2.2- 271, p = 0.009), glucose-6-phosphate dehydrogenase deficiency (G6PD) (OR: 21.1, 95% CI = 1.8-238.4, p = 0.01), early discharge (OR: 14.4, 95% CI = 4.2-48.9, p = <0.001) and male sex (OR: 4.3, 95% CI = 1.3-14.1, p = 0.02) were independently associated with an increased risk for exchange transfusion. Being refugee (OR: 6.8, 95% CI = 1.8-25.8, p = 0.005) and G6PD deficiency (OR: 9.9, 95% CI = 1.3-71.9, p = 0.02) were associated with development of ABE.\n\n\nCONCLUSION\nEarly discharge, Rh isoimmunization and G6PD deficiency are significant risk factors for severe hyperbilirubinemia and exchange transfusion. Prevention of early hospital discharges, family education to increase awareness for hazardous effects of hyperbilirubinemia and early follow-up visits after discharge would reduce the disease burden.