Neonatal jaundice in a Special Care Baby Unit (SCBU) in Port Harcourt, Nigeria: a prospective study

Abstract

Objectives: To determine the incidence, related factors, management and outcome of neonatal jaundice among inborn and outborn babies seen at the University of Port Harcourt Teaching Hospital.
Methods: A 6-month prospective study spanning from 1st July to 31st December 2002 of all neonates with significant jaundice admitted into the Special Care Baby Unit of the University of Port Harcourt Teaching Hospital was carried out. Data from the mothers and babies were entered into a specially designed questionnaire and statistical analysis was carried out by χ2, Fisher\'s exact probability and Student\'s t tests.
Results: The overall incidence of neonatal jaundice was 21.4%; 27.8% in outborn and 16.4% in inborn babies. Septicaemia was the major associated factor in outborn, while preterm delivery was the main factor in inborn babies, the jaundice being more severe in outborn babies. The best predictor of kernicterus was the peak serum unconjugated bilirubin concentration (two-tailed unpaired t=2.49, df=5, p=0.015). The overall case-fatality rate was 34.1%, being 60% and 40% among outborn and inborn babies respectively.
Conclusion: Septicaemia and preterm delivery were found to be the main associated factors in severe unconjugated hyperbilirubinaemia and was more severe in outborn babies, the dominant reason was considerable delay in presenting to hospital. There was therefore need for prompt recognition and treatment of septicaemia and efforts should be focused at the community level to encourage mothers to present early in hospital as soon as jaundice is noticed.


Keywords: Neonatal unconjugated hyperbilirubinaemia, Associated factors, Kernicterus, Outcome

PHMJ Vol. 2 (2) 2008: pp. 110-117