Laboratory Assessment for the Diagnosis of Jaundice in Newborns: Laboratory Assessment for the Diagnosis of Jaundice in Newborns

Amjad Mahmood Qadir; Ali Hasan Ali; Qaraman Salih Mahmood; Rebaz Anwar Omer; Dara Latif Saifaddin

doi:10.63841/iue31626

Authors

Amjad Mahmood Qadir Department of General Science, College of Basic Education, University of Halabja, 46018 Halabja, Kurdistan Region, IRAQ Author https://orcid.org/0000-0002-4142-6118
Ali Hasan Ali Maternity and Paediatric Hospital of Halabja, Ministry of Health, 46018 Halabja, Kurdistan Region, IRAQ Author https://orcid.org/0000-0003-2730-6686
Qaraman Salih Mahmood Maternity and Paediatric Hospital of Halabja, Ministry of Health, 46018 Halabja, Kurdistan Region, IRAQ Author https://orcid.org/0009-0004-2125-5050
Rebaz Anwar Omer Department of Chemistry, Faculty of Sciences and Health, Koya University, Koya 44023, Kurdistan Region – F.R. IRAQ Author https://orcid.org/0000-0002-3774-6071
Dara Latif Saifaddin Department of Sport Sciences for Health and Performance, College of Physical Education and Sport Sciences, University of Halabja, 46018 Halabja, Kurdistan Region, IRAQ Author https://orcid.org/0000-0002-6134-3678

DOI:

https://doi.org/10.63841/iue31626

Keywords:

Neonatal hyperbilirubinemia, Total serum bilirubin, Caesarean delivery, Blood group incompatibility, Packed cell volume

Abstract

Background: Hyperbilirubinemia is a primary cause of jaundice in babies. To perform early risk assessments and provide effective therapy, you need to understand what factors affect total serum bilirubin (TSB) levels. Objective: This study aimed to investigate the relationship between TSB levels and various parameters, including mode of delivery, maternal and neonatal blood types, gender, weight, and packed cell volume (PCV) in infants. Methods: The 74 neonates, aged 1 to 30 days, were admitted to either a neonatal intensive care unit or an outpatient clinic for this cross-sectional study. One-way ANOVA and independent t-tests were performed to examine the relationships between TSB levels and the selected factors. Result: The findings indicated no significant correlations between TSB levels and the following variables: gender (p = 0.640), weight (p = 0.652), PCV (p = 0.076), caesarean birth (p = 0.509), maternal blood group (p = 0.127), and infant blood type (p = 0.450). The effect sizes were small (Cohen's d < 0.2) for the average TSB levels for vaginal and caesarean births, which were 11.80 ± 3.55 mg/dL and 12.36 ± 3.42 mg/dL, respectively. Conclusion: The study found that newborn hyperbilirubinemia is not affected by delivery mode, maternal or fetal blood type, gender, weight, or packed cell volume. These findings reveal that hepatic immaturity, hemolysis, nursing behaviors, and genetic vulnerability are among the many factors that may alter bilirubin metabolism. Clinical management should focus on established risk factors, including gestational age and hemolysis symptoms. The environmental and genetic determinants of neonatal jaundice outcomes require thorough longitudinal examination.

Downloads

Download data is not yet available.

Author Biographies

Amjad Mahmood Qadir , Department of General Science, College of Basic Education, University of Halabja, 46018 Halabja, Kurdistan Region, IRAQ

Amjad M. Qadir is an Assistant Lecturer at the Department of General Science, College of Basic Education, University of Halabja. He got the B.Sc. degree in Chemistry and the M.Sc. degree in Biochemistry. His research interests are in Cancers, Lipids, Oxidative Stress, Carbohydrates, Antioxidants and Hormones. Amjad is a member of the Kurdistan Chemists and Physics Society, attended the Chemical Security Risk Assessment Training at the Academic Institutions in the Kurdistan Region of Iraq national workshop, and published Several Original and Review papers.
Ali Hasan Ali , Maternity and Paediatric Hospital of Halabja, Ministry of Health, 46018 Halabja, Kurdistan Region, IRAQ

Ali H. Ali is working at the Maternity and Paediatric Hospital of Halabja. He got the B.Sc. degree in Chemistry and the M.Sc. degree in Clinical Biochemistry. He has much experience in the Clinical Biochemistry Laboratory. His research interests are in Lipids, Carbohydrates, and Hormones.
Rebaz Anwar Omer, Department of Chemistry, Faculty of Sciences and Health, Koya University, Koya 44023, Kurdistan Region – F.R. IRAQ

Rebaz Anwar Omer is a assistant Prof at the Department of chemistry at Koya University. He got the BSc in chemistry and the MSc in organic chemistry and the PhD in organic and computational chemistry. His research is interesting in organic and computational chemistry
Dara Latif Saifaddin , Department of Sport Sciences for Health and Performance, College of Physical Education and Sport Sciences, University of Halabja, 46018 Halabja, Kurdistan Region, IRAQ

Dara L. Saifaddin is an Assistant Professor at the Department of Sport Sciences for Health and Performance, College of Physical Education and Sport Sciences, University of Halabja. He got the B.Sc. degree in Chemistry, the M.Sc. degree in Biochemistry, and the PhD degree in Biochemistry. His research interests are in Cancers, Lipids, Oxidative Stress, Carbohydrates, Antioxidants and Hormones. Dara has published Several Original and Review papers.

References

H. Boskabadi, M. Sezavar, and M. Zakerihamidi, "Evaluation of neonatal jaundice based on the severity of hyperbilirubinemia," Journal of Clinical Neonatology, vol. 9, no. 1, pp. 46-51, 2020.

A. Esan, "Hemolytic disorders of the newborn, current methods of diagnosis and treatment: a review study," J Hematol Blood Transfus Disord, vol. 3, no. 008, 2016.

S. R. Panch and C. Montemayor, "Hemolytic transfusion reactions," Rossi's Principles of Transfusion Medicine, pp. 543-552, 2022.

B. O. Olusanya, F. B. Osibanjo, and T. M. Slusher, "Risk factors for severe neonatal hyperbilirubinemia in low and middle-income countries: a systematic review and meta-analysis," PloS one, vol. 10, no. 2, p. e0117229, 2015.

T. W. R. Hansen, R. J. Wong, and D. K. Stevenson, "Molecular Physiology and Pathophysiology of Bilirubin Handling by the Blood, Liver, Intestine, and Brain in the Newborn," Physiological Reviews, vol. 100, no. 3, pp. 1291-1346, 2020, doi: 10.1152/physrev.00004.2019.

C. Dim et al., "Effect of dietary inclusion of biochar on growth performance, haematology and serum lipid profile of broiler birds," Agro-Science, vol. 17, no. 2, pp. 9-17, 2018.

Y. A. Aynalem, G. B. Mulu, T. Y. Akalu, and W. S. Shiferaw, "Prevalence of neonatal hyperbilirubinaemia and its association with glucose-6-phosphate dehydrogenase deficiency and blood-type incompatibility in sub-Saharan Africa: a systematic review and meta-analysis," (in eng), BMJ paediatrics open, vol. 4, no. 1, p. e000750, 2020, doi: 10.1136/bmjpo-2020-000750.

K. Wu, L. Chen, H. Huang, and D. Chen, "A Comparative Analysis of the Efficacy of Blood Exchange Therapy in Neonatal Hyperbilirubinemia Induced by ABO and Rh Incompatibility," International Journal of General Medicine, pp. 5921-5927, 2024.

S. Mahapatra, K. Patra, S. Panda, S. Behuria, P. K. Sahu, and M. M. Majhi, "Hyperbilirubinemia in neonates with blood group incompatibilities − A bane or a boon for the management," Transfusion Clinique et Biologique, vol. 32, no. 1, pp. 82-86, 2025/02/01/ 2025, doi: https://doi.org/10.1016/j.tracli.2025.01.004.

S. Sharma, S. B. Lal, M. Sachdeva, A. Bhatia, and N. Varma, "Role of granulocyte colony stimulating factor on the short-term outcome of children with acute on chronic liver failure," Journal of Clinical and Experimental Hepatology, vol. 10, no. 3, pp. 201-210, 2020.

K. Sayaf, D. Gabbia, F. P. Russo, and S. De Martin, "The role of sex in acute and chronic liver damage," International Journal of Molecular Sciences, vol. 23, no. 18, p. 10654, 2022.

M. Davenport, E. Makin, E. G. Ong, K. Sharif, M. Dawrant, and N. Alizai, "The outcome of a centralization program in biliary atresia: 20 years and beyond," Annals of Surgery, p. 10.1097, 2024.

U. Abiha, D. S. Banerjee, and S. Mandal, "Demystifying non-invasive approaches for screening jaundice in low resource settings: a review," Frontiers in Pediatrics, vol. 11, p. 1292678, 2023.

B. H. Ali, "Evaluation and Correlation of Hepcidin-25 Hormone, Hemoglobin and Packed Cell Volume of Patients with β-Thalassaemia Intermedia Before and After Blood Transfusion for Iraqi Children Patients," Ibn AL-Haitham Journal For Pure and Applied Science, vol. 31, no. 3, pp. 70-78, 2018.

P. Scepanovic et al., "A comprehensive assessment of demographic, environmental, and host genetic associations with gut microbiome diversity in healthy individuals," Microbiome, vol. 7, pp. 1-15, 2019.

I. Shoris et al., "“Light” on Phototherapy—Complications and Strategies for Shortening Its Duration, A Review of the Literature," Children, vol. 10, no. 10, p. 1699, 2023.

P. Saha, S. K. Mukherjee, and S. T. Hossain, "Regulation of TCA cycle genes by srbA sRNA: Impacts on Pseudomonas aeruginosa virulence and survival," Biochemical and Biophysical Research Communications, vol. 737, p. 150520, 2024.

H. Boskabadi, F. Rakhshanizadeh, and M. Zakerihamidi, "Evaluation of maternal risk factors in neonatal hyperbilirubinemia," Archives of Iranian medicine, vol. 23, no. 2, pp. 128-140, 2020.

Y. Huang et al., "Maternal knowledge, attitudes and practices related to neonatal jaundice and associated factors in Shenzhen, China: a facility-based cross-sectional study," BMJ open, vol. 12, no. 8, p. e057981, 2022.

G. A. Bagwell and D. K. Steward, "Hematologic system," Comprehensive Neonatal Nursing Care, vol. 5, pp. 334-375, 2019.

C. Toly‐Ndour et al., "Rh disease prevention: the European Perspective," ISBT Science Series, vol. 16, no. 1, pp. 106-118, 2021.

G. Bancone et al., "Contribution of genetic factors to high rates of neonatal hyperbilirubinaemia on the Thailand-Myanmar border," PLOS Global Public Health, vol. 2, no. 6, p. e0000475, 2022.

H. Wu, R. Li, H. Wei, W. Zhu, and Y. Xing, "Clinical Characteristics and Prognosis of Hemolytic Disease of the Newborn Caused by Irregular Antibodies: A 13-Year Retrospective Analysis," Children, vol. 11, no. 12, p. 1409, 2024.

S.-D. Neamţu et al., "Fetal–maternal incompatibility in the Rh system. Rh isoimmunization associated with hereditary spherocytosis: case presentation and review of the literature," Romanian Journal of Morphology and Embryology, vol. 63, no. 1, p. 229, 2022.

B. A. van der Geest et al., "Severe neonatal hyperbilirubinaemia: lessons learnt from a national perinatal audit," Archives of Disease in Childhood-Fetal and Neonatal Edition, vol. 107, no. 5, pp. 527-532, 2022.

I. M. Ree et al., "Exchange transfusions in severe Rh‐mediated alloimmune haemolytic disease of the foetus and newborn: a 20‐year overview on the incidence, associated risks and outcome," Vox Sanguinis, vol. 116, no. 9, pp. 990-997, 2021.

P. Rahfeld and S. G. Withers, "Toward universal donor blood: Enzymatic conversion of A and B to O type," Journal of Biological Chemistry, vol. 295, no. 2, pp. 325-334, 2020, doi: 10.1074/jbc.REV119.008164.

S. Alshammari, A. Alqashami, S. Alhumud, M. Aladadh, S. Alsaif, and K. Ali, "Neonatal ABO Incompatibility, Influence of Blood Group, and Coomb's Test on Outcome," Journal of Clinical Neonatology, vol. 11, no. 4, pp. 212-218, 2022.

S. Ullah, K. Rahman, and M. Hedayati, "Hyperbilirubinemia in neonates: types, causes, clinical examinations, preventive measures and treatments: a narrative review article," Iranian journal of public health, vol. 45, no. 5, p. 558, 2016.

L. He, J. Hu, Y. Han, and W. Xiong, "Predictive modeling of postoperative gastrointestinal dysfunction: the role of serum bilirubin, sodium levels, and surgical duration in gynecological cancer care," BMC Women's Health, vol. 23, no. 1, p. 598, 2023.

M. Thomas et al., "Current and emerging technologies for the timely screening and diagnosis of neonatal jaundice," Critical reviews in clinical laboratory sciences, vol. 59, no. 5, pp. 332-352, 2022.

J. P. Ndabakuranye et al., "70 years of bilirubin sensing: towards the point-of-care bilirubin monitoring in cirrhosis and hyperbilirubinemia," Sensors & Diagnostics, vol. 1, no. 5, pp. 932-954, 2022.

T. N. Flores-Téllez, S. Villa-Treviño, and C. Piña-Vázquez, "Road to stemness in hepatocellular carcinoma," World journal of gastroenterology, vol. 23, no. 37, p. 6750, 2017.

R.-Y. Zhang et al., "Conjugation of TLR7 and TLR7/8 agonists onto weak protein antigen via versatile oxime ligation for enhanced vaccine efficacy," International Journal of Biological Macromolecules, vol. 278, p. 134620, 2024.

H.-T. Huang et al., "Osteoprotective roles of green tea catechins," Antioxidants, vol. 9, no. 11, p. 1136, 2020.

N. Roy-Chowdhurya, P. Aspf, and C. Guhad, "Bilirubin metabolism and its," Hepatology: An Evidence-Based Clinical Compendium, p. 51, 2024.

F. J. Suchy, "Functional development of the liver," In J. Bezerra, C. Mack, & B. Shneider (Authors) & F. Suchy, R. Sokol, & W. Balistreri (Eds.), Liver Disease in Children, pp. 12-25, 2021.

C.-X. Fu et al., "Diagnostic Efficacy and Possible Underlying Mechanisms of Noninvasive Clinical Markers in Hepatocellular Carcinoma," Journal of Clinical and Translational Hepatology, vol. 11, no. 4, p. 889, 2023.

A. S. Martins, F. Flor-DE-Lima, G. Rocha, P. Soares, A. P. Machado, and M. H. Guimarães, "Neonatal polycythemia: prevalence, risk factors and predictors of severity," Minerva Pediatrics, vol. 76, no. 1, pp. 64-71, 2024.

T. W. Hansen, R. J. Wong, and D. K. Stevenson, "Molecular physiology and pathophysiology of bilirubin handling by the blood, liver, intestine, and brain in the newborn," Physiological reviews, vol. 100, no. 3, pp. 1291-1346, 2020.

N. R. Chowdhury, Y. Li, and J. R. Chowdhury, "Disorders of Bilirubin Metabolism," in The Liver, 2020, pp. 229-244.

A. V. Hoffbrand and A. B. Mehta, "Haematological Aspects of Systemic Disease," in Postgraduate Haematology, 2015, pp. 838-853.

R. Patel, M. Islam, N. Sarvaiya, and K. Wadhwani, "Impact of Water Deprivation and Rehydration on Blood Parameters of Sheep under Middle Gujarat Agro-Climatic Condition," Int. J. Curr. Microbiol. App. Sci, vol. 9, no. 6, pp. 104-109, 2020.

T. M. Bahr, R. D. Christensen, and M. Kaplan, "Hemolytic causes of neonatal jaundice: diagnosis and treatment," Pediatric Medicine, vol. 4, 2021.

B. O. Olusanya, M. Kaplan, and T. W. Hansen, "Neonatal hyperbilirubinaemia: a global perspective," The Lancet Child & Adolescent Health, vol. 2, no. 8, pp. 610-620, 2018.

C. M. Scifres, "Short-and long-term outcomes associated with large for gestational age birth weight," Obstetrics and Gynecology Clinics, vol. 48, no. 2, pp. 325-337, 2021.

J. F. Watchko, "Review of the contribution of genetic factors to hyperbilirubinemia and kernicterus risk in neonates: a targeted update," Pediatric Medicine, vol. 4, 2021.

Z. Luo et al., "The role of male hormones in bacterial infections: enhancing Staphylococcus aureus virulence through testosterone-induced Agr activation," Archives of Microbiology, vol. 206, no. 10, p. 401, 2024.

Laboratory Assessment for the Diagnosis of Jaundice in Newborns