Risk Factors of Severe Hyperbilirubinemia in Neonates Undergoing Exchange Transfusion in Imam Reza Hospital Kermanshah- Iran, during 2012 to 2016

Background Jaundice is one of the most common problems in neonatal period. Although the efficacy of exchange transfusion in the treatment of neonatal jaundice is knownand quickly reduces blood bilirubin levels, but severe neonatal hyperbilirubinemia is associated with significant morbidity and mortality. We conducted this study to investigate the risk factorsof severe hyperbilirubinemia in neonates undergoing exchange transfusion in Imam Reza Hospital Kermanshah, Iran. Materials and Methods In this retrospective study, records of newborns with hyperbilirubinemia who were undergoing exchange transfusion to Imam Reza hospital in Kermanshah from of 2012 to 2016 were studied. Information were extracted from the patient case and recorded in the data collection form. Data analyzed using SPSS software (version 24.0). Results Birth weight of 42.1% of neonates was less than 2,500 gr and 43.1% were preterm. The most common causes of severe hyperbilirubinemia including: unknown causes (42.2%, n=38), ABO incompatibility (27.8%, n=25), and sepsis (12.2%, n=11). The most common complications of exchange transfusion in this study were thrombocytopenia (33.4%), hypocalcaemia (18.7%), hyperglycemia (12.3%), and hypoglycemia (12.3%). Conclusion According to the results, major risk factors for the occurrence of severe hyperbilirubinemia in neonates were birth weight less than 2,500 gram, gestational age below 37 weeks, age less than 5 days, and weight loss more than 10% of birth weight at the time of admission.