Prevalence, risk factors and short-term outcome of babies with Neonatal Jaundice in a secondary facility with free-health services in South-West, Nigeria

Abstract

Neonatal Jaundice (NNJ) is a common occurrence in about 60% of term infants and 80% of preterm infants worldwide and a leading cause of hospitalization during the first week of life. Available evidence suggests that low- and middle-income countries (LMICs) bear the greatest burden of severe neonatal jaundice characterized by very high rates of morbidity, mortality and long-term sequel compared to high-income countries (HICs). Aims: To document the prevalence, risk factors and short-term outcome of babies with neonatal jaundice in a secondary health facility with free health services in South-West Nigeria. Method: Babies were recruited from both in-born and out-born arms of the Special Care Baby Unit (SCBU). It was a prospective study of all babies admitted for neonatal jaundice from January to December 2014; the babies were followed up till discharge. Patients’ information including socio-demographic characteristics, risk factors, treatment modalities and outcomes were collected and entered directly into an Excel sheet. Results: There were a total of 1,309 admissions: 734 males and 575 females giving a M: F ratio of 1.3:1. NNJ was present in 125 (9.5%) of them. Thirty-five (28%) of the affected babies were preterm babies while 90 (72%) were term babies. Ten (8%) of them presented within the first 24 hours of life, 103 babies (82.4%) presented between 1^st and 7^th day of life while 12 (9.6%) presented after the 7^th day of life. Neonatal sepsis, prematurity, perinatal asphyxia and prolonged rupture of membrane (PROM) were the leading causes and risk factors for NNJ in our setting. One hundred and seven (85.6%) of them had only phototherapy as treatment modality while 18 (14.4%) had exchange blood transfusion (EBT). One hundred and twenty babies (96%) were discharged alive, 5 (4%) had bilirubin encephalopathy and 2 babies (1.6%) died. Conclusion: Neonatal Jaundice is common in our setting with possible dire consequences. Health education of the public on its associated modifiable risk factors is desirable.