An Observational Study to Determine Etiological Profile of Neonates Admitted With Indirect Hyperbilirubinemia at Sms Medical College and Hospital, Jaipur, Rajasthan

Abstract

Introduction: Neonatal hyperbilirubinemia is one of the most common causes of neonatal morbidity and hospital admissions, particularly in developing countries. While most cases are physiological and self-limiting, a significant proportion progress to pathological jaundice, which may result in acute bilirubin encephalopathy and kernicterus if untreated. This study was undertaken to evaluate the clinical profile, etiological factors, and outcomes of neonates with indirect hyperbilirubinemia.

Materials and Methodology: This prospective observational study was conducted in the Department of Paediatric Medicine and associated hospitals of SMS Medical College, Jaipur, from April 2023 to November 2024. A total of 135 neonates (<28 days old) with indirect serum bilirubin levels in the phototherapy range, as per AAP guidelines, were included. Clinical, demographic, and laboratory data were recorded. Investigations included serum bilirubin, blood grouping, Coombs test, sepsis screening, and hemolysis evaluation. Management was carried out according to AAP protocols, with phototherapy or exchange transfusion as indicated. Data were analyzed using SPSS software.

Results: Among 135 neonates, males (55.56%) predominated over females (44.44%). Most cases presented between 96–168 hours of life (49.62%). The leading cause of jaundice was ABO incompatibility (40.7%), followed by physiological jaundice (22.2%), Rh incompatibility (10.4%), sepsis (10.4%), perinatal asphyxia (7.4%), cephalohematoma (5.9%), and idiopathic cases (3%). Phototherapy was effective in 87.4% of cases, while 12.6% required exchange transfusion. Most neonates (94.1%) were discharged; mortality occurred in 3.7%, and 1.5% were discharged with sequelae.

Conclusion: ABO incompatibility was the most frequent cause of neonatal jaundice. Early recognition and timely management with phototherapy or exchange transfusion are crucial in preventing bilirubin-induced complications and improving neonatal outcomes.