ABSTRACT
Hyperbilirubinemia is one of the most common problems encountered in newborns. Nowadays it was noticed to be seen more than before, representing an important medical, social, and economic health problem. A number of epidemiologic factors may exert their influence on increasing the occurrence of neonatal jaundice. To estimate the prevalence of neonatal jaundice in Minoufyia governorate using the judgment of Integrated Management of Childhood Illness [IMCI] project for the detection of clinically significant jaundice and to identify some of its risk factors with spotting light on the role of family physician in the management. This study was carried out on 300 fullterm and preterm neonates [153 males, and 147 females], selected from three hospitals and two Maternal and Child Health Centers in Shebin El Kom City and districts. The study design composed of two main parts: A cross sectional study [200 cases], to estimate the prevalence of jaundice among neonates [group I], and: A case control study [100 cases], to identify the important risk factors for occurrence of neonatal jaundice [group IIA, B]. The prevalence of clinically significant neonatal jaundice was 17%. Some neonatal risk factors were found to be significantly increased among jaundiced babies compared to controls: low birth weight, prematurity, and infection [P values 0.02, 0.01, and 0.001 respectively]. However in comparing, sex, breast feeding, cephalhematoma, the difference was found to be insignificant. As regard maternal factors, the use of oxytocin during first stage of labor, was the only significant risk factor [P value 0.01], however, maternal age, education, consanguinity, jaundice of previous sibling, intake of iron and tonics, abdominal ultrasound, and mode of delivery were insignificant factors. The most common cause of pathological jaundice was infection, and the most commonly used treatment was phototherapy. More cases were referred from primary health physicians [PHP] compared to specialists with a significantly earlier age at referral [3.7+ 0.21 days in cases referred from PHP and 5.45 + 0.31 days in those of specialists]. However the outcome of cases didn't differ significantly between cases referred from PHP compared to specialists. The prevalence of neonatal jaundice is high in Minoufyia. A significant relation was found between the occurrence of neonatal jaundice and some maternal and neonatal risk factors which need to be reevaluated on a larger scale. The clinical criteria of the IMCI project for diagnosis and referral of jaundiced newborn are very beneficial and need to be generalized and supported by a scheduled neonatal follow up early after birth