Dilek KURNAZ, Burcu CEBECİ, Betül Zehra PİRDAL, Derya BÜYÜKKAYHAN
Journal of Health Sciences and Medicine - 2026;9(3):576-582
Aims: This study aimed to investigate the etiology and risk factors associated with indirect neonatal hyperbilirubinemia (INH) and their effects on the duration of hospital stay. Methods: A total of 400 term newborns with INH were included in the study. Demographic characteristics, feeding practices, total serum bilirubin levels, phototherapy duration, and length of hospital stay were recorded. Risk zones for hyperbilirubinemia were determined using the Bhutani nomogram, and the significance of associated factors was assessed using Chi-square and Fisher's exact tests. Results: Of the 400 newborns, 51.5% were male, with a mean gestational age of 38.67+/-1.11 weeks and a mean birth weight of 3286.6+/-450.4 g. Twenty-five percent of the infants were classified in the high-risk zone for hyperbilirubinemia. Infants in the high-risk group were admitted at a significantly older postnatal age and required longer phototherapy duration compared with those in the intermediate-high risk group. Positive direct Coombs (DC) test and mixed feeding were significantly associated with prolonged phototherapy duration (>2 days). Furthermore, early-term infants were found to have a higher risk of developing severe hyperbilirubinemia. Gestational age, feeding method, DC positivity, parity, and phototherapy duration were identified as significant determinants of hospital stay. Conclusion: This study identified key risk factors associated with prolonged hospital stay in term newborns with INH, including DC positivity and mixed feeding practices. These findings highlight the importance of early identification and appropriate management of at-risk infants to reduce the severity of hyperbilirubinemia and associated hospitalization duration.
