Sociodemographic and Service Utilization Factors as Determinants of Severe Neonatal Jaundice: A Case–Control Study

Mousumi Datta, Indrani Das, Kundan Sharma, Sandip Samanta

Abstract

Background: Severe neonatal jaundice can cause bilirubin encephalopathy. There is an incomplete understanding of the sociodemographic determinants of neonatal jaundice in India.

Aims: To describe the cases and controls according to their demographic and disease profiles and to estimate the effect of added risk of adverse sociodemographic, maternal, perinatal, and poor service utilization factors on the incidence of severe jaundice in neonates at admission

Materials and Methods: Data of neonates born between March 2019 and February 2020 were considered for this case–control study. The neonates with venous blood total serum bilirubin (TSB) ≥ 15 mg/dL at admission constituted the cases, and the neonates with TSB of 10 to 14.9 mg/dL constituted the controls. The mean TSB level and demographic, perinatal, and service utilization factors in cases and controls were statistically analyzed.

Results: A total of 327 neonates were included, of which, 125 were cases and 202 were controls. The mean TSB of the cases was significantly higher than that of the controls (21.98 vs 12.2 mg/dL, respectively). In both the groups, the onset of jaundice was between days 2 and 7 of life. We found that the sociodemographic factors, including low maternal education and residence in rural areas, and the service utilization factors, including not availing the minimum recommended antenatal checkups and Matri Yan, delivering at home, and a delay of > 48 hours between the diagnosis of severe jaundice in the neonates and their hospital admission to be the factors responsible for an increased risk of severe jaundice.

Conclusion: The delayed hospitalization of neonates with severe jaundice was found to be because of low maternal education and poor utilization of maternal and child health care services. The mothers’ ability to detect the signs of jaundice in their neonates early will aid in timely seeking of medical help.