4 • PERINATOLOGY Vol 24 • No. 1 • May–Aug 2023 cases and controls. The risk of severe jaundice (TSB ≥ 15 mg/dL) at admission was significantly high in neonates whose parents resided in rural areas and maternal education was low. Table 3 shows a comparison of the maternal and perinatal risk factors among the cases and controls. Low maternal age, primiparity, and neonatal birth weight < 2.5 kg were associated with a high risk of severe jaundice (TSB ≥ 15 mg/dL) at admission. In terms of service-related factors, the risk of jaundice (TSB ≥ 15 mg/dL) at admission was significantly high when the minimum recommended ANC visits, Matriyaan, and institutional delivery were not availed and when there was delay of ≥ 48 hours between the diagnosis of neonatal jaundice and hospital admission (Table 4). Table 1. Distribution of Cases and Controls According to the Disease Profile Variable Cases (n = 125), Frequency (%) Controls (n = 202), Frequency (%) TSB, Mean (SD) 21.98 (9.2) 12.2 (1.8) Age at Onset of Jaundice < 24 h 7 (5.6) 12.2 (1.8) 24 h to 7 d 102 (81.6) 0 (0) > 7 d 16 (12.8) 200 (99) Person Who First Detected Jaundice Mother 33 (26.4) 142 (70.3) Doctor 32 (25.6) 28 (13.9) Health Worker 60 (48.0) 32 (15.8) Neonates Who Received Home Remedies and Medications Yes 89 (71.2) 98 (48.5) No 36 (28.8) 104 (51.5) Neonates Who Required Exchange Transfusion Yes 63 (50.4) 1 (0.5) No 62 (49.6) 201 (99.5) Table 2. A Comparison of the Demographic and Socioeconomic Characteristics of the Cases and Controls Variable Cases (n = 125), Frequency (%) Controls (n = 202), Frequency (%) COR (95% CI) P Value Median Age of the Neonates, d 4 6 — Sex Male 75 (60) 117 (57.9) 1.08 (0.69–1.71) .71 Female 50 (40) 85 (42.1) Area of Residence Rural 60 (48) 60 (29.7) 2.18 (1.37–3.47)a .0009 Urban 65 (52) 142 (70.3) Maternal Educationb Lower than primary 33 (26.3) 21 (10.4) 3.09 (1.69–5.64)a .0002 Primary 88 (70.4) 166 (82.2) Secondary 4 (3.3) 15 (7.4) Average Monthly Family Incomeb ≤ 2000 59 (47.2) 90 (44.5) 1.11 (0.71–1.74) .64 2001–5000 30 (24.0) 32 (15.8) 5001–10000 31 (24.8) 69 (34.2) > 10,000 5 (4.0) 11 (5.5) aP < .01; bHigher categories (primary and secondary, 5001–10,000 and > 10,000) were clubbed for COR calculation. Research Article Datta M, et al. Determinants of Severe Neonatal Jaundice Table 3. A Comparison of the Maternal and Perinatal Factors in the Cases and Controls Variable Cases (n = 125), Frequency (%) Controls (n = 202), Frequency (%) COR (95% CI) Maternal Age, y < 25 87 (69.6) 103 (50.9) 2.20 (1.37–3.52)a .001 ≥ 25 38 (30.4) 99 (49) Parity Primiparous 98 (78.4) 102 (50.5) 3.54 (2.14–5.91)a .0001 Multiparous 27 (21.6) 100 (49.5) Known Maternal Risk Factor Yes 46 (36.8) 60 (29.7) 1.31 (0.85–2.21) .18 No 79 (63.2) 142 (70.3) Mode of Delivery Vaginal 90 (72) 131 (64.8) 1.39 (0.85–2.26) .18 Cesarean 35 (28) 71 (35.2) Gestational Age Term 112 (89.6) 172 (85.1) 1.50 (0.75–3.00) .24 Preterm 13 (10.4) 30 (14.9) Birth Weight, kg < 2.5 52 (41.6) 61 (30.2) 1.64 (1.03–2.62)b .03 ≥ 2.5 73 (58.4) 141 (69.8) EIBF Yes 119 (95.2) 188 (93.1) 1.47 (0.55–3.94) .4 No 6 (04.8) 14 (06.9) EIBF, early initiation of breastfeeding. aP < .01; bP < .05.
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