Risk factors for neonatal jaundice in babies presenting at the University of Benin Teaching Hospital, Benin City
Background: Jaundice is the yellowish discoloration of the skin, sclera and mucous membranes resulting from deposition of bilirubin. Neonatal jaundice is a leading cause of neonatal admissions in the first week of life and risk factors such as sepsis, prematurity, glucose-6-phosphate dehydrogenase enzyme deficiencies, use of native herbs and contact with naphthalene balls contaminated clothes have been identified for neonatal jaundice. Objective: To determine the risk factors for neonatal jaundice at University of Benin Teaching Hospital, Benin City. Methods: This retrospective study was conducted at the Special Care Baby Unit of the University of Benin Teaching Hospital, Benin City. Case notes of babies admitted from January 2006 to December 2008 were retrieved and information on biodata, gestational age, anthropometric values, potential risk factors, level of serum bilirubin at presentation and discharge, mode of treatment and outcome were extracted. Results: Of the 1784 babies admitted during the period, 472 (26.5%) were admitted for neonatal jaudice. Fifty seven percent of the babies with neonatal jaundice were delivered in UBTH (in-born babies), while 202 (42.8%) of the babies were born before arrival (out-born babies) in UBTH. The Male: Female ratio was 1.02:1. The mean age at presentation with jaundice was 3.43 ± 3.76 days of life. Outborn babies tended to present at an older age (6.08 ± 5.19 days) than in -born babies (2.47 ± 2.48 days). The mean serum bilirubin value in out-born babies (14.00 ± 4.58 mg/dL) was significantly higher than that observed among the in-born babies (9.35 ± 4.38 mg/dL: p = 0.000). The risk factors identified were use of mentholatum, naphthalene balls and native herbs in 40.0%, 16.7% and 7.0% respectively. ABO incompatibility was found in 7.6% of babies. No risk factor was identified in 36.3% of the babies. The case fatality rate in this study was relatively high particularly in association with sepsis, prematurity and asphyxia. Mortality was higher in out-born babies than in in-born babies (p= 0.00). Conclusion: Early presentation of babies and adequate management of sepsis and prematurity will reduce mortality associated with neonatal jaundice.
Key words: In-born, jaundice, outborn, risk, sepsis.