Prevalence and Risk Factors of Neonatal Jaundice in Iraqi Hospitals: A Study at the Obstetric and Pediatrics Hospital, Samawah

Introduction: Neonatal jaundice (hyperbilirubinemia) is one of the most common clinical conditions globally and is the second leading cause of neonatal hospitalization worldwide. However, the epidemiology and specific risk factors of neonatal jaundice remain poorly described in Iraq, especially in the provinces. This study aimed to examine the epidemiology of neonatal jaundice and to identify maternal, neonatal, and perinatal risk factors associated with requiring phototherapy for neonatal jaundice at a major referral center in Samawah, Iraq. Methods: A retrospective cross-sectional study of all live-born neonates who were born at or admitted to the Obstetric and Pediatrics hospital in Samawah from January 1, 2022 to December 31, 2022 was conducted. Maternal, neonatal demographics, delivery data, and management of jaundice data were collected from hospital records. Neonates with total serum bilirubin levels meeting the criteria for phototherapy established by the American Academy of Pediatrics (AAP) were considered to be cases of significant jaundice. Chi-square tests and logistic regression were used during statistical analysis to identify independent risk factors. Results: The overall incidence of jaundice requiring phototherapy was 682 cases (14.1%) out of 4,850 live births. of these, 530 were classified as either physiologic or breastfeeding-related jaundice (78.2% of cases), while 152 cases (21.8%) had identifiable pathologic causes of jaundice on evaluation. The following independent risk factors were found to be significantly associated with needing phototherapy for neonatal jaundice: gestational age <37 weeks (AOR = 3.45, 95% CI: 2.67-4.46), birth weight <2500 g (AOR = 2.89, 95% CI: 2.18-3.83), male gender (AOR = 1.52, 95% CI: 1.25-1.85), primiparity (AOR = 1.48, 95% CI: 1.21-1.80), maternal age <20 years (AOR = 1.92, 95% CI: 1.45-2.55) and prior sibling history of jaundice (AOR = 2.95, 95% CI: 2.15- 4.05). of the neonates with jaundice, ABO incompatibility was noted in 8.5%. Conclusion: The prevalence of significant neonatal jaundice in this sample of neonates from Iraq is high, and there are many independent risk factors contributing to the development of neonatal jaundice in this population, including prematurity, low birth weight, male gender, being a primiparous mother, being less than 20 years of age, and a prior sibling with jaundice. The results of this study highlight the need for thorough prenatal screenings, close monitoring for jaundice following delivery, and intensified education for at-risk mothers receiving health care services in Iraq.