Outcomes of neonatal hyperbilirubinemia and associated factors at a tertiary hospital in Ghana

IntroductionNeonatal Hyperbilirubinemia (NH) is one of the most common clinical presentations in the first week of life.AimsThis study sought to determine the incidence, clinical presentation and risk factors associated with mortality, among neonates presenting with unconjugated NH at the Komfo Anokye Teaching Hospital in Ghana.MethodologyThis was a hospital-based prospective analytical cohort study conducted from October to December 2020. A total of 223 newborns admitted to the nursery with NH were recruited, mothers were interviewed, and patients were followed-up until discharge. Data was collected and analyzed with R statistical software. Associations were determined as crude and adjusted odds ratios using univariate and multivariate binomial logistic regression.ResultsThe incidence of NH was 244 per 1000 admissions (95% CI: 21.7-27.3) with a case fatality rate of 8.1% (95% CI: 4.8-12.4). Independent predictors of increased mortality were older age at admission [AOR = 1.28(1.05-1.57), p = 0.015], gestational age between 35 and 37 weeks [AOR = 4.89(1.04-25.8), p = 0.047], and the presence of abnormal posture at admission [AOR = 6.40(1.37-35.9), p = 0.023]. The presentations associated with survival till discharge were primiparity in the mother [AOR = 0.06(0.01, 0.32), p = 0.003], and exclusive breastfeeding at the time of admission [AOR = 0.09 (0.02-0.46), p = 0.004].ConclusionThe incidence of hyperbilirubinemia among neonates admitted to the Mother Baby Unit at KATH is high and gestational ages between 35 and 37 weeks, abnormal posture and older age at presentation were identified to be significantly associated with mortality.