Background: Neonatal mortality rate in Indonesia from demographic and health survey in 2012 exceed 19/1000 live births. A prolong hyperbilirubinemia in neonates equal to or greater than 35 weeks increased risk of kernicterus, bilirubin encephalopathy, other neurological defect, even death. Based on that fact, it was important to understand about hyperbilirubinemia risk factors among newborn.
Methods: This research was case-control study conducted at Atma Jaya Jakarta Hospital dan Siloam Karawaci Tangerang Hospital. Newborn data was grouped as case group with total bilirubin serum =8,5 mg/dL in the first 48 hours and control group with total bilirubin <8,5 mg/dL. Statistical tests were non-parametric Mann-Whitney and chi-square for analysing risk factors of newborn hiperbilirubinemia: food intake, polychythemia, mother’s gestation age, blood incompatibility, and cephalhematoma.
Results: A total medical records of 223 newborns were taken from two hospitals RSAJ (n=28) and Siloam (n=195) consisted of 120 cases and 103 controls. Chi-square and Mann-Whitney analysis found that breastmilk+formula frequency (p=0,15), breastmilk only (p=0,91), formula only (p=0,32) in 48 hours, food intake status (p=0,59), urine frequency (p=0,59), hemoglobin (p=0,15), parity status (p=0,70), rhesus incompatibility (p=1,00), gestational status (p=0,56), and cephalhematoma (p=0,25) were statistically not significant (CI:95%; a:0.05) with neonatal hyperbilirubinemia. Blood incompatibility was significantly increased risk of newborns 1,78 times to develop hyperbilirubinemia (OR: 1,78; p=0,04; CI:95%; a:0.05). Mother with O blood type has higher bilirubin compared to other blood types (11,4 vs 9,1; p=0,03; CI:95%; a:0.05).
Conclusion: Newborns food intake, polycythemia, mother gestation age, and cephalhematoma do not increase hyperbilirubinemia risk in newborns, but ABO blood groups incompatibility was proved to increase the risk of hiperbilirubinemia in newborns of = 35 weeks gestational age in the first 48 hours of life. Thus, important to consider ABO incompatibility status especially mother with O blood type. |