Neonatal Jaundice, Risk Factors and Implication of Direct Coombs Test as a Model of Severity. A Retrospective Study from One Single Center in South Lebanon

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Background: Neonatal indirect hyperbilirubinemia is a common disorder in newborns of multifactorial etiologies with different presenting symptoms.Severe jaundice may cause kernicterus, and multiple metabolic disturbances.Objective: To understand the importance of direct coombs test (DCT) and other risk factors in determining the severity and the prognosis of jaundice.Methods: This is a retrospective study over a 1-year period extending from July 2018 till June 2019.All newborns admitted to the neonatal intensive care unit at a tertiary healthcare center in South Lebanon; with the diagnosis of neonatal hyperbilirubinemia were recruited in the study.Demographic data, laboratory results and the clinical courses of participant's newborns were recorded.SPSS was used to carry out statistical analyses.Results: 119 newborns were successfully enrolled in the present study, ABO incompatibility especially O-A, was the most common cause for indirect hyperbilirubinemia (31%).It was also associated with the highest encounter of positive coombs test (31%) results compared to other types of ABO incompatibility (20%).Cases of rhesus incompatibility were associated with higher total and indirect bilirubin peak level; longer hospital stay and longer duration of phototherapy (150.00 ± 55.68 Vs 88.17 ± 37.37 hours).Jaundice with NDCT was associated with urinary tract infection.Conclusion: Neonatal jaundice should be well investigated to determine the exact etiology and its underlying pathology that will clarify the prognosis, mode of treatment and its economic burden.Urinary tract infection or sepsis remain possible causes of neonatal jaundice when an unidentified cause for the jaundice is identified.

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