Prevalence of Hyperbilirubinemia Among Inborn Neonates Admitted to a Tertiary NICU in the Central Terai Region of Nepal

Introduction: Neonatal hyperbilirubinemia is among the most common health problems of newborns, especially in resource-limited settings like Nepal. Limited treatment access and delayed diagnosis increase the risk of having severe complications. This study aimed to assess the prevalence of neonatal jaundice in a tertiary Neonatal Intensive Care Unit (NICU) in Central Terai belt of Nepal.  Methods: A descriptive cross-sectional study was conducted at a tertiary care centre from February 13 to December 16, 2024, after obtaining ethical approval from the Institutional Review Committee. Neonates admitted to the NICU with bilirubin ≥7 mg/dL in serum were included. Data were collected from 515 neonates, using an Excel sheet, and analyzed using SPSS v26.0. 95% Confidence Interval and point estimate accordingly were calculated. Convenience sampling was used.  Results: Among 515 admitted neonates in the NICU, Hyperbilirubinemia was present in 175 (33.98%). Most of them were males (67.4%) and preterms (41.7%). Sepsis (38.29%), ABO incompatibility (22.29%), and birth asphyxia (16.57%) were found to be the leading causes. Phototherapy was administered in 90.29% of cases, with a median duration of 26 hours. Exchange transfusion was required in 2.29% of cases. After treatment, median total serum bilirubin decreased from 12.4 to 11.1 mg/dL. Most neonates (87.4%) recovered and were discharged.  Conclusions: The prevalence of hyperbilirubinemia among neonates was found to be lower in comparison to other studies done in similar settings. However, Sepsis and ABO incompatibility were still observed to be key contributors. Early diagnosis improved antenatal care, and access to effective treatment, like phototherapy and exchange transfusion were crucial to reduce morbidity and mortality.