Clinical Outcomes and Determinants of Neonatal Hyperbilirubinemia Among NICU Admissions: A Retrospective Study in Ethiopia

Neonatal hyperbilirubinemia is a significant clinical concern in developing nations. This institution-based retrospective cross-sectional study assessed the clinical outcomes and determinants of jaundice at the Asella Referral and Teaching Hospital (ARTH) NICU in South East Ethiopia. Out of 183 randomly selected neonates, the prevalence of hyperbilirubinemia was 16.4% (95% CI: 11–21.8). The majority of jaundiced neonates presented with high admission total serum bilirubin levels between 15 and 19 mg/dL. Multivariate logistic regression identified inadequate breastfeeding (AOR 9.507, 95% CI: 1.244–72.671, p = 0.030) and neonatal sepsis (AOR 3.707, 95% CI: 1.337–10.276, p = 0.012) as the primary independent predictors. Clinical outcomes were generally positive (93.3% improvement), though high admission bilirubin levels suggest delays in recognition. Management was robust, with 26.7% requiring exchange transfusion. These findings highlight the urgent need for universal pre-discharge screening and robust lactation support to mitigate preventable neurological sequelae in Ethiopian neonates.