Evaluation of Maternal Risk Factors in Neonatal Hyperbilirubinemia

Diagnosis and timely treatment of neonatal jaundice and prevention of dangerous side effects of pathologic neonatal jaundice remain a serious debate. The first step in prevention of jaundice is the identification of predisposing factors. The present study aims to systematically review the maternal risk factors of neonatal hyperbilirubinemia.

For this study, we searched databases including Science Direct, Cochrane Library, ISI, PubMed and Google Scholar from 1993 to 2017. The keywords searched based on MESH included hyperbilirubinemia, jaundice, infants, mothers and risk factors. The present systematic review was conducted on studies reporting maternal risk factors for neonatal jaundice. The inclusion criteria were: study on neonates; examination of maternal factors or both maternal and neonatal factors. Papers associated with the diagnosis and treatment of neonatal jaundice were excluded from the study, as well as those articles for which only abstracts were available. The limitations of this study include lack of access to all relevant articles, lack of qualified reports in some papers, and the limitation in number of articles related to maternal risk factors, and therefore inability to judge accurately about their effects on neonatal jaundice.

Of 500 searched articles, 17 articles (1 prospective article, 2 retrospective papers, 12 cross-sectional papers and 2 historical cohort articles) were finally investigated. Maternal risk factors included hypertension, diabetes, type of delivery, vaginal bleeding, premature rupture of membranes (PROM), maternal age, lack of initiation of feeding during the first hours of life, inappropriate breastfeeding techniques and presence of maternal breast problems.

The most common maternal risk factors for neonatal jaundice were prematurity, blood type incompatibilities, preeclampsia, hypertension, diabetes mellitus, vaginal bleeding, delivery problems (type of delivery, labor injuries, delivery at home, skin ecchymosis, and cephalohematoma), mothers and community cultural beliefs (use of traditional supplements), breast problems, and decrease in breastfeeding.