A Retrospective Study on Clinical Features of Early Neonatal Jaundice in Term Babies at Ratchaburi Hospital, Thailand

Abstract

Background: Neonatal jaundice is a common condition that sometimes lead to devastating neurological consequence such as kernicterus. Aim: This study was aimed to find out the clinical features and etiology of neonatal jaundice in term newborn admitted to Ratchaburi Hospital. Study Design:  Hospital-based retrospective study Methodology: The study was conducted by reviewing 117 medical records of neonatal jaundice who were admitted at Ratchaburi Regional Hospital, Bangkok, Thailand from 1st October 2007 to 30th September 2008. Both the patient’s and their mother’s profiles, etiology and clinical features of jaundice were extracted. Results: The results showed that the most common etiology was inconclusive jaundice (64.9%) followed by ABO incompatibility (17.9%) and breast feeding jaundice (10.2%). Other less common causes were G6PD deficiency, minor blood group incompatibility and cephalhematoma. The onset of the neonatal jaundice usually occurred on the 2nd to the 4th day of life and almost all newborns responded well to phototherapy. Most of interventions were started on the 2nd day of life. Moreover, exchange transfusion was needed in four cases. The maximum and minimum haematocrit was significantly lower while Nucleated Red Cell (NRC) count and percent of reticulocytes counts were significantly higher in haemolysis group than in non-haemolysis group,. Conclusion: From our study, the most common etiology was inconclusive jaundice which is followed by ABO incompatibility but non-immune hemolysis and polycythemia were not encountered. There was significant difference of hematocrit, NRC and reticulocytes between hemolytic and non-hemolytic groups. Detailed approach of history taking and physical examination, early investigations of jaundice work up and septic work up are recommended in eliciting various etiologies and preventing complications.