Exaggerated Physiological Jaundice and Exchange Transfusion in Neonates

Area of Science:

• Neonatology
• Pediatrics
• Public Health

Background:

• Neonatal jaundice, especially unconjugated hyperbilirubinemia, is common and can lead to bilirubin-induced neurologic dysfunction (BIND).
• While physiological jaundice is usually benign, severe cases may require phototherapy or exchange transfusion.
• This study investigated the incidence and risk factors for exaggerated physiological jaundice necessitating exchange transfusion in neonates.

Purpose of the Study:

• To determine the incidence of exaggerated physiological jaundice requiring exchange transfusion in neonates.
• To identify the contributing factors associated with this condition.
• To inform management strategies for reducing severe neonatal hyperbilirubinemia.

Main Methods:

• A retrospective case series analysis of medical records from January 2020 to January 2023.
• Inclusion criteria: neonates with physiological hyperbilirubinemia (serum bilirubin ≥17 mg/dL) who underwent exchange transfusion.
• Data collected: demographics, clinical signs, feeding practices, laboratory findings; analyzed using IBM SPSS Statistics.

Main Results:

• Out of 136 neonates with exaggerated jaundice, 20 (14.7%) required exchange transfusion.
• Common contributing factors identified: exclusive breastfeeding (76.2%), low birth weight (23.8%), and prematurity (14.3%).
• Mean total serum bilirubin decreased from 26.52 ± 7.7 mg/dL to 14.16 ± 2.6 mg/dL post-exchange transfusion.

Conclusions:

• A notable 14.7% of neonates with exaggerated physiological jaundice needed exchange transfusion.
• Exclusive breastfeeding, low birth weight, and prematurity were significant contributing factors.
• Early identification, close monitoring, and targeted interventions are crucial for managing neonatal jaundice and preventing severe outcomes.