Clinical outcomes and determinants of neonatal hyperbilirubinemia among NICU admissions: a retrospective study in Ethiopia

Neonatal hyperbilirubinemia is a significant public health concern in Ethiopia, contributing to approximately 10% of neonatal mortality. This study aimed to identify the clinical outcomes and determinants of jaundice among neonates admitted to the Neonatal Intensive Care Unit (NICU) at Asella Referral and Teaching Hospital (ARTH) in South East Ethiopia. The objective of this study was to assess the magnitude of neonatal hyperbilirubinemia, its clinical outcomes, and the maternal and neonatal determinants among neonates admitted to the ARTH NICU. An institution-based retrospective cross-sectional study was conducted using systematic random sampling (K = 7), 183 neonates were selected randomly from a source population of 1,350 admissions. Data were analyzed using multivariate logistic regression to identify independent predictors of hyperbilirubinemia, with statistical significance set at p < 0.05. The prevalence of hyperbilirubinemia was 16.4%( n = 30; 95% CI: 11-21.8). Among these jaundiced neonates, 46.7% (n = 14) presented with high admission total serum bilirubin levels ranging from 15 to 19 mg/dL, and 26.7% (n = 8) required exchange transfusion. Inadequate breastfeeding (AOR 9.51, 95% CI: 1.24-72.67, p = 0.030) and neonatal sepsis (AOR 3.71, 95% CI: 1.34-10.28, p = 0.012) were the primary independent predictors. The high admission bilirubin levels and significant need for exchange transfusion highlight the urgent need for universal pre-discharge screening and robust lactation support.