Risk factors for exchange transfusion in neonates with unconjugated hyperbilirubinemia: A tertiary care hospital study.

Objective: To assess the prevalence of exchange transfusion requirement and identify risk factors associated with exchange transfusion in neonates with unconjugated hyperbilirubinemia in a tertiary care hospital. Study Design: Comparative Cross-sectional. Setting: Department of Neonatology, Holy Family Hospital Rawalpindi. Period: January 2022 to December 2022. Material & Methods: A total of 136 neonates, from 28 weeks of gestation to 28 days of life after birth, with severe pathological hyperbilirubinemia, unconjugated hyperbilirubinemia and or who had signs of kernicterus were included through non-probability consecutive sampling. Patients were then divided in to two groups based on exchange transfusion received or not. SPSS version 26 was used for data entry and analysis, and descriptive and inferential statistics were applied. Results: A total of 136 neonates were recruited, out of which 57% (n=78) were male and 43% (n=58) were female. The average gestational age was 36.6 ± 1.9 weeks. 111 (82%) neonates were term, while 25 (18%) were preterm. The average age of the study population was 6.0±3.3 days, with a mean weight of 2.7 ± 0.7 kg. The average STB level was 20.8 ± 5.5 mg/dl. 64.7% (n=88) required exchange transfusion were belonged to group-A, while 35.3 %(n=48) without exchange transfusion were in group-B. The burden of disease was calculated to be 64.7%. Polycythemia, ABO and Rh incompatibility were identified as significant risk factors for ET (p<0.05). Conclusion: The burden of disease was 64.7%. Exchange transfusion was required in the majority of neonates with unconjugated hyperbilirubinemia. The identified risk factors for the requirement of exchange transfusion in neonates were polycythemia, ABO and Rh incompatibility.