Etiological Spectrum of Neonatal Jaundice in Neonatal Intensive Care Unit in Tertiary Care Hospital

Background: Neonatal jaundice is a frequent cause of hospital admissions in newborns and can result from a range of physiological and pathological conditions. Early identification of its underlying etiology is essential to guide appropriate management and prevent complications, especially in resource-limited settings where diagnostic tools may be limited. Objective: To determine the frequency of the causes of neonatal jaundice in the neonatal intensive care unit in tertiary care hospital. Study Design: Descriptive cross-sectional study. Duration and Place of Study: The study was conducted from January to May 2025 at the Neonatal Intensive Care Unit, Department of Pediatrics, CMH Abbottabad. Methodology: A total of 164 neonates under 28 days of age with clinical and biochemical evidence of jaundice were included using non-probability consecutive sampling. Neonates with prior phototherapy, congenital anomalies, or life-threatening illness were excluded. Data were collected on demographic characteristics and laboratory evaluations to establish the etiology of jaundice. Results: The most common cause of neonatal jaundice was physiological jaundice (47.6%), followed by ABO incompatibility (25.6%) and Rh incompatibility (11.6%). Statistically significant associations were observed between Rh incompatibility and male gender (p=0.043), ABO incompatibility and rural residence (p=0.007), and physiological jaundice with family history (p=0.021) and urban residence (p<0.001). ABO incompatibility also showed a significant correlation with low birth weight (p=0.049). Conclusion: Physiological jaundice remains the most prevalent cause of neonatal jaundice, while Rh and ABO incompatibilities also contribute significantly.