Prevalence and Risk Factors of Neonatal Hyperbilirubinemia in a Semi-Rural Area of the Democratic Republic of Congo: A Cohort Study
Issued Date
2023-01-01
Resource Type
ISSN
00029637
eISSN
14761645
Scopus ID
2-s2.0-85174856719
Pubmed ID
37669757
Journal Title
American Journal of Tropical Medicine and Hygiene
Volume
109
Issue
4
Start Page
965
End Page
974
Rights Holder(s)
SCOPUS
Bibliographic Citation
American Journal of Tropical Medicine and Hygiene Vol.109 No.4 (2023) , 965-974
Suggested Citation
Fanello C., Lee S.J., Bancone G., Kayembe D., Ndjowo P., Badjanga B., Gornsawun G., Chotthanawathit P., Waithira N., White N.J., Onyamboko M. Prevalence and Risk Factors of Neonatal Hyperbilirubinemia in a Semi-Rural Area of the Democratic Republic of Congo: A Cohort Study. American Journal of Tropical Medicine and Hygiene Vol.109 No.4 (2023) , 965-974. 974. doi:10.4269/ajtmh.23-0293 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/90884
Title
Prevalence and Risk Factors of Neonatal Hyperbilirubinemia in a Semi-Rural Area of the Democratic Republic of Congo: A Cohort Study
Other Contributor(s)
Abstract
Neonatal hyperbilirubinemia (NH) is a frequent condition that, if left untreated, can lead to neurological disability and death. We assessed the prevalence of NH and associated neonatal and maternal risk factors in 362 mothers and 365 newborns in a semi-rural area of the Democratic Republic of Congo. In addition, we explored the knowledge and practices of mothers regarding this condition. We collected demographic data, anthropometric data, and obstetric and medical anamneses. We examined newborns at birth and at 24, 48, and 72 hours and measured bilirubin at birth in umbilical cord and capillary blood and thereafter in capillary blood. Hemoglobin, hematocrit, ABO group, Rhesus factor, glucose-6-phosphate dehydrogenase (G6PD) deficiency, Hemoglobin S (HbS), and malaria were assessed in mothers and newborns. Among 296 newborns (all time points available), 5.7% developed NH (95% CI: 3.4–9.0) between 24 and 72 hours according to National Institute for Health and Care Excellence (NICE) UK guidelines. There was a significantly higher risk in newborns with G6PD deficiency (homo- and hemizygous adjusted Odd Ratio [aOR]: 21.0, 95% CI: 4.1–105.9), preterm births (aOR: 6.1, 95% CI: 1.4–26.9), newborns with excessive birth weight loss (aOR: 5.8, 95% CI: 1.4–23.2), and hyperbilirubinemia at birth (aOR: 14.8, 95% CI: 2.7–79.6). Newborns with feto-maternal ABO incompatibility and G6PD deficiency had significantly higher bilirubin at birth than others. More than 60% of mothers had adequate knowledge of NH, but compliance with phototherapy in the absence of symptoms was low. Although risk factors for NH are common in this area, prevalence was not high, suggesting a need for better case definition. Implementation of point-of-care devices for diagnosis and awareness programs on risk prevention could help reduce neonatal morbidity and mortality associated with hyperbilirubinemia in these areas.