Brobby Naana Ayiwa Wireko, Nguah Samuel Blay, Yakubu Rafiuk Cosmos, Plange-Rhule Gyikua, Yiadom Adwoa P Boakye, Ocran Akua Afriyie, Ashong Joyce
Department of Child Health, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, P.O. Box 1098, Kumasi, Ghana.
Directorate of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
BMC Pediatr. 2025 Apr 2;25(1):267. doi: 10.1186/s12887-025-05618-4.
Neonatal Hyperbilirubinemia (NH) is one of the most common clinical presentations in the first week of life.
This study sought to determine the incidence, clinical presentation and risk factors associated with mortality, among neonates presenting with unconjugated NH at the Komfo Anokye Teaching Hospital in Ghana.
This was a hospital-based prospective analytical cohort study conducted from October to December 2020. A total of 223 newborns admitted to the nursery with NH were recruited, mothers were interviewed, and patients were followed-up until discharge. Data was collected and analyzed with R statistical software. Associations were determined as crude and adjusted odds ratios using univariate and multivariate binomial logistic regression.
The incidence of NH was 244 per 1000 admissions (95% CI: 21.7-27.3) with a case fatality rate of 8.1% (95% CI: 4.8-12.4). Independent predictors of increased mortality were older age at admission [AOR = 1.28(1.05-1.57), p = 0.015], gestational age between 35 and 37 weeks [AOR = 4.89(1.04-25.8), p = 0.047], and the presence of abnormal posture at admission [AOR = 6.40(1.37-35.9), p = 0.023]. The presentations associated with survival till discharge were primiparity in the mother [AOR = 0.06(0.01, 0.32), p = 0.003], and exclusive breastfeeding at the time of admission [AOR = 0.09 (0.02-0.46), p = 0.004].
The incidence of hyperbilirubinemia among neonates admitted to the Mother Baby Unit at KATH is high and gestational ages between 35 and 37 weeks, abnormal posture and older age at presentation were identified to be significantly associated with mortality.
新生儿高胆红素血症（NH）是出生后第一周最常见的临床表现之一。
本研究旨在确定加纳Komfo Anokye教学医院出现非结合型NH的新生儿的发病率、临床表现以及与死亡率相关的危险因素。
这是一项于2020年10月至12月进行的基于医院的前瞻性分析队列研究。共招募了223名因NH入住新生儿病房的新生儿，对其母亲进行了访谈，并对患者进行随访直至出院。使用R统计软件收集和分析数据。采用单变量和多变量二项式逻辑回归确定关联的粗比值比和调整比值比。
NH的发病率为每1000例入院病例244例（95%可信区间：21.7 - 27.3），病死率为8.1%（95%可信区间：4.8 - 12.4）。死亡率增加的独立预测因素为入院时年龄较大[AOR = 1.28(1.05 - 1.57)，p = 0.015]、孕龄在35至37周之间[AOR = 4.89(1.04 - 25.8)，p = 0.047]以及入院时存在异常姿势[AOR = 6.40(1.37 - 35.9)，p = 0.023]。与存活至出院相关的表现为母亲初产[AOR = 0.06(0.01, 0.32)，p = 0.003]以及入院时纯母乳喂养[AOR = 0.09 (0.02 - 0.46)，p = 0.004]。
KATH母婴病房收治的新生儿中高胆红素血症的发病率较高，孕龄在35至37周之间、异常姿势以及就诊时年龄较大被确定与死亡率显著相关。
