Aspect épidémiologique de l’ictère néonatal au niveau du service de néonatologie de l’EHS mère-enfant lala kheira Mostaganem.

Abstract

Jaundice is an extremely common symptom in the neonatal period, it is the clinical expression of the deposition of bilirubin in the various tissues of the body. This high frequency is due to metabolic peculiarities in newborns. The evolution is most often benign, however jaundice can sometimes progress to neurotoxicity with a risk of permanent sequelae. The objective of this work is to analyze the clinical, etiological and therapeutic characteristics of a population of jaundiced term and premature newborns. This work concerns a retrospective analytical epidemiological survey at the level of the neonatology department of the hospital specialized "Mother and Child Lala Kheira" in Mostaganem, during the period which ran from April 1 to 30 of the current year. A male predominance was recorded with 61% of cases and a sex ratio of 1.6. 17% of newborns are premature. Jaundice is early in 30% of cases. The average age at admission is 5 days and the average length of hospitalization in our series is 3 days. Bilirubin levels at admission ranged from extremes of 54.9 mg/l to 407 mg/l. no significant relationship was established between the total bilirubin level and gender (p=0.486), mode of delivery (p=0.469) and breastfeeding (p=0.273). Anemia is present in 22% of newborns, CRP is positive in 57% and the Coombs test is positive in 4% of cases. The etiologies revealed are dominated by physiological jaundice (35% of cases), followed ABO incompatibility in 17% of cases, prematurity in 13%, neonatal infection and unknown etiology in 9%, Serum eruption, kernicterus, hypothyroidism and Rh incompatibility, each of these etiologies in 4% of cases. Treatment is essentially based on phototherapy associated with etiological treatment. A newborn has benefited from exchange transfusion. Despite the favorable evolution of jaundice in all newborns, it remains a frequent symptom at risk of serious complications requiring treatment in specialized neonatology structures with careful assessment of risk factors and early detection.