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Updated: Nov 21, 2025
Biochemical Measurement of Neonatal Hypoxia
Published on: August 24, 2011
Hyperbilirubinemia in Preterm Infants Admitted to Neonatal Intensive Care Units in Ethiopia
Sara Aynalem1, Mahlet Abayneh1, Gesit Metaferia1
1St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Insights
Hyperbilirubinemia, or jaundice, is common in preterm infants in Ethiopia. Key risk factors include ABO incompatibility, sepsis, and Rh isoimmunization, necessitating targeted interventions.
Area of Science:
- Neonatal Medicine
- Pediatrics
- Public Health
Background:
- Hyperbilirubinemia (jaundice) is a frequent and prolonged condition in preterm infants.
- This study specifically investigated the patterns and prevalence of hyperbilirubinemia in Ethiopian preterm infants.
Purpose of the Study:
- To assess the prevalence and identify risk factors associated with hyperbilirubinemia in preterm infants in Ethiopia.
- To understand the clinical presentation and outcomes of hyperbilirubinemia in this vulnerable population.
Main Methods:
- A multi-centered, prospective, cross-sectional, observational study was conducted.
- Jaundice was initially identified clinically, with serum bilirubin levels measured for diagnosis (≥5 mg/dL).
- Data were collected on preterm infants admitted to neonatal intensive care units.
Main Results:
- Of 3852 preterm infants in NICUs, 1779 (46.2%) had hyperbilirubinemia.
- Prevalence was higher (66.7%) in infants <28 weeks gestation who survived.
- Significant risk factors included Rh incompatibility (P=.002), ABO incompatibility (P=.0001), and sepsis (P=.0001).
Conclusions:
- Hyperbilirubinemia is highly prevalent in Ethiopian preterm infants admitted to neonatal care.
- ABO incompatibility, sepsis, and Rh isoimmunization are major identified risk factors.
- Early identification and management of these risk factors are crucial for improving outcomes.
Abstract:
Background. Hyperbilirubinemia is prevalent and protracted in preterm infants. This study assessed the pattern of hyperbilirubinemia in preterm infants in Ethiopia. Methods. This study was part of multi-centered prospective, cross-sectional, observational study that determined causes of death among preterm infants. Jaundice was first identified based on clinical visual assessment. Venous blood was then sent for total and direct serum bilirubin level measurements. For this study, a total serum bilirubin level ≥5 mg/dL was taken as the cutoff point to diagnose hyperbilirubinemia. Based on the bilirubin level and clinical findings, the final diagnoses of hyperbilirubinemia and associated complications were made by the physician. Result. A total of 4919 preterm infants were enrolled into the overall study, and 3852 were admitted to one of the study's newborn intensive care units. Of these, 1779 (46.2%) infants were diagnosed with hyperbilirubinemia. Ten of these (0.6%) developed acute bilirubin encephalopathy. The prevalence of hyperbilirubinemia was 66.7% among the infants who were less than 28 weeks of gestation who survived. Rh incompatibility (P = .002), ABO incompatibility (P = .0001), and sepsis (P = .0001) were significantly associated with hyperbilirubinemia. Perinatal asphyxia (P-value = 0.0001) was negatively associated with hyperbilirubinemia. Conclusion. The prevalence of hyperbilirubinemia in preterm babies admitted to neonatal care units in Ethiopia was high. The major risk factors associated with hyperbilirubinemia in preterm babies in this study were found to be ABO incompatibility, sepsis, and Rh isoimmunization.
