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Abstract
Background: Indirect hyperbilirubinemia is still one of the most prevalent problems among preterm newborns, especially in low- and middle-income countries. Immaturity in bilirubin metabolism, higher bilirubin burden, and delayed identification all raise the likelihood of severe illness and bilirubin-induced neurological dysfunction. The aim of this study was to assess the prevalence and risk factors for indirect hyperbilirubinemia in preterm newborns hospitalized to the neonatology unit of Hayatabad Medical Complex in Peshawar.
Methods: This cross-sectional study was undertaken from November 1st, 2024 to April 30th, 2025. A total of 196 preterm newborns (gestational ages 28-36 weeks) were recruited via non-probability sequential sampling. The sample size was derived using the WHO single proportion formula, with a 15% predicted prevalence. Indirect hyperbilirubinemia was defined as total bilirubin >1.5 mg/dL and indirect fraction >1.2 mg/dL. Relevant demographic and clinical data were gathered. Data were evaluated using SPSS v25, and p < 0.05 was considered statistically significant.
Results: The average gestational age was 33.26 ± 2.34 weeks and the average birth weight was 1.88 ± 0.43 kg. Indirect hyperbilirubinemia was seen in 26% of neonates, with 68.6% mild, 27.5% moderate, and 3.9% severe. Gestational age was significantly associated with hyperbilirubinemia (p = 0.012), with the highest occurrence occurring between 28 and 31 weeks. There were no significant relationships with gender, mode of delivery, birth weight, or socioeconomic status.
Conclusion: Indirect hyperbilirubinemia affects one in every four preterm neonates, especially those with lower gestational age. Early screening, consistent phototherapy regimens, and increased community awareness are critical for decreasing severe disease and complications.