Advances in Nursing & Midwifery

Abstract

Background

Hyperbilirubinemia occurs in most neonates. Most cases are benign but newborns should be monitored because of potential toxicity of bilirubin and possible occurrence of severe hyperbilirubinemia and, in rare cases, acute bilirubin encephalopathy or kernicterus. Maternal, neonatal and perinatal factors provide evidence for the possibility of severe neonatal hyperbilirubinemia.

Purpose

This cross-sectional study was conducted to determine the incidence rate and maternal as well as neonatal factors associated with hyperbilirubinemia at Hedayat Hospital in Tehran.

Methods

All neonates (1292 newborns) from 21^st of December to 19^th of March were selected. A questionnaire was used for data collection.

Results

The incidence rate was 19.9%. Maternal factors in newborns with hyperbilirubinemia included age=26.6 years; gravidity=1.6 times, pregnancy duration=38.8 weeks, labor duration=8.19 hours, oxytocin dosage= 22.85 units and premature rupture of membrane duration=6.66 hours. Most mothers had blood group O (52.1%), positive Rh factor (92.5%), no familial history of jaundice (88.7%), normal vaginal delivery (53.5%), epidural anesthesia during normal delivery (95.2%), general anesthesia during Caesarian section (60.7%) and no instrumental delivery (69.9%). Neonatal factors in newborns with hyperbilirubinemia included weight=3016.4 gr., rank of birth=1.44, age=3.5 days, bilirubin amount=15.3 mg/dl, nutrition frequency=12.53 times and bowel elimination frequency=4.4 times in 24 hours. In addition, most affected neonates were male (54.6%), with no labor injuries (95.5%), exclusive nutrition of breast milk (100%) and initiation of nutrition in less than 2 hours after birth (99.6%). A significant relationship was found between gravidity as well as Rh factor from maternal risk factors and age as well as bowel elimination frequency from neonatal risk factors and neonatal bilirubin (P<0.05).

Conclusion

Eliminating these and other risk factors is critical for health promotion of society.