Risk Factors for Non-Hemolytic Jaundice in Neonates: A Retrospective Cohort Study at Naresuan University Hospital

Background: Neonatal hyperbilirubinemia is a common neonatal condition requiring immediate diagnosis and treatment to prevent severe hyperbilirubinemia that can cause brain damage known as kernicterus. Identifying risk factors and monitoring at-risk infants can help reduce the incidence of severe hyperbilirubinemia. Materials and Methods: The present study was a retrospective cohort study analyzed medical records of infants with gestational age (GA) of more than 35 weeks born at Naresuan University Hospital between January 2019 and December 2020. One thousand fifteen infants were enrolled and divided into two groups: the hyperbilirubinemia group comprising 287 infants (28.3%), and the non-hyperbilirubinemia group consisting of 728 infants (71.7%). Results: The incidence of neonatal hyperbilirubinemia in infants with GA of more than 35 weeks was 30.7% (345 out of 1,122). Compared to vaginal delivery, cesarean section reduced the risk of neonatal hyperbilirubinemia by 32% (adjusted odds ratio 0.68). Sepsis increased the risk of neonatal hyperbilirubinemia by 73% (adjusted odds ratio 1.73). Infants in the hyperbilirubinemia group had a longer hospital stay, averaging approximately 28 hours. Conclusion: Vaginal delivery and neonatal sepsis were identified as significant risk factors for neonatal hyperbilirubinemia. Close monitoring of infants identified as at-risk may aid in the prevention of severe hyperbilirubinemia.