Evaluation of the hematological profile of neonatal jaundice among neonates in Erbil city

Arazu Ali  Zendin; Nawsherwan Sadiq  Mohammad; Rawand Polus  Shamoon

doi:10.56056/amj.2025.319

Authors

Arazu Ali Zendin M.B.Ch.B, KHCMS trainee, Nanakali teaching hospital, Erbil, Iraq
Nawsherwan Sadiq Mohammad FIMBS, consultant hematopathologist, Hawler, Medical university, Erbil, Iraq
Rawand Polus Shamoon Ph.D hematopathology, Hawler, Medical university, Erbil, Iraq

DOI:

https://doi.org/10.56056/amj.2025.319

Keywords:

Cross-sectional study, G6PD, Hyperbilirubinemia, Jaundice, Neonate

Abstract

Background and objectives: Neonatal jaundice is the most commonly encountered medical problem in the first two weeks of life, and a common cause of readmission to the hospitals, this study is designed to investigate different hematological parameters in neonatal jaundice and compare them to normal infants, to determine the association ofhematological profile of different etiologies of jaundice in neonates.

Methods: This prospective cross-sectional study, investigates blood samples of 600 neonates (300 healthy and 300 jaundice confirmed neonates, regardless of genders), that were admitted to Raparin Pediatric Teaching, and Erbil Maternity Teaching Hospitals, from July 2022 to July 2023. Samples were subjected to the hematological investigations, including complete blood count (CBC), ABO, and Rh for both the fetus and the mother. Additionally, direct antiglobulin test (Coomb´s), reticulocytes count, and G6PD enzyme assay were also assessed.

Results: Clinical presentation of neonatal jaundice showed that more than half (57.8%) of the cases were males, and 42.2% were females, oxytocin used for 31.2% of mothers during delivery; 6.5% of patients faced Rh-incompatibility and just 11.3% faced ABO- incompatibility. The most common etiologies for neonatal jaundice were physiological (64%), while others were pathological (36%). Among the pathological, the ABO incompatibility was (20.7%), followed by Rh incompatibility (9%), and G6PD deficiency (6.3%). There was a significance correlation between the jaundice type and evaluated hematological profiles for each group.

Conclusion: Most of the neonatal jaundice cases were physiological in nature, with ABO incompatibility as the most common type, while G6PD was the least common pathological type.

Downloads

Download data is not yet available.

References

Aisha AA, Haji BA, Aldoski AA. G6PD Deficiency Prevalence as a Cause of Neonatal Jaundice in a Neonatal Ward in Dohuk, Iraq. Am J Perinatol. 2021;38(6):575-80.

Alkhotani A, Eldin EE, Zaghloul A, Mujahid S. Evaluation of neonatal jaundice in the Makkah region. Sci Rep. 2014; 4:48-52.

Asadullah S, Afsanah H, Kuboi T, Tiranah T. Phototherapy for neonatal hyperbilirubinemia in Iran. Iran Pediatr Int. J. 2019; 59(9):959-66.

Bhutani VK. Committee on Fetus and Newborn. American Academy of Pediatrics. Phototherapy to prevent severe neonatal hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Na J Pediatrics. 2011; 128(4): 1046-52.

Lucanova L, Matasova K, Zibolen M, Krcho P. Accuracy of transcutaneous bilirubin measurement in newborns after phototherapy in Macedonia. J Perinatol. 2016; (10):858-61.

Chang PF, Lin YC, Liu K, Yeh SJ, Ni YH. Prolonged unconjugated hyperbilirubinemia in breast-fed male infants in China with a mutation of uridine diphosphate-glucuronosyl transferase. J Pediatr. 2019; 155:860-63.

D?di? T, Jirsa M, Keil R, Rygl M, Šnajdauf J, Kotalová R. Alagille syndrome mimicking neonatal jaundice in early infancy in Nepal. PLoS J. 2017; 10: 143-39.

Garratty G, Glynn SA, McEntire R. ABO and Rh(D) phenotype frequencies of different racial/ethnic groups in the United States. Transfusion. 2004; 44: 703–6.

Gol E, Smith D, Sholin M. Guidelines for detection, management and prevention of hyperbilirubinemia in term and late preterm newborn infants in USA- Summary. Ped Child Health J. 2007; 12(5):401-18.

Itoh S, Okada H, Kuboi T, Kusaka T. Phototherapy for neonatal hyperbilirubinemia. Japan Pediatr Int. J. 2019; 59(9):959-66.

Kumral A, Ozkan H, Duman N, Yesilirmak DC, Islekel H, Ozalp Y. Breast milk jaundice correlates with high levels of epidermal growth factor. Pediatr Res J. 2017; 66:218-21.

Kaplan M, Rubaltelli FF, Hammerman C. Conjugated bilirubin in neonates with glucose-6-phosphate dehydrogenase deficiency. Tur J Pediatr. 2017; 128:695-97.

Maisels MJ, Clune S, Coleman K The natural history of jaundice in predominantly breastfed infants. Pediatrics Int. J. 2016; 134: e340-5.

Moreira-Silva SF, Frauches DO, Almeida AL, Mendonça HF. Acute liver failure in children: observations in Vitória, Espírito Santo State, Brazil. Rev Soc Bras Med Trop J. 2016; 35:483-86.

Long J, Zhang S, Fang X, Luo Y, Liu J. Neonatal hyperbilirubinemia and Gly71Arg mutation of UGT1A1 gene: A Chinese case-control study followed by systematic review of existing evidence. Acta Paediatr. 2017; 100:966- 71.

Zeki LD, Sibel LM, Arias IM. Review of international data of neonatal jaundice across different nations. Turkish J Pediatr. 2016; 68:54-66.