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 Table of Contents  
ORIGINAL ARTICLE
Year : 2019  |  Volume : 8  |  Issue : 2  |  Page : 116-119

Mothers' perception of neonatal jaundice in Jazan Region, KSA


1 Medical College, Jazan University, Jazan, Saudi Arabia
2 Neonatology Department, King Fahad Central Hospital (KFCH), Jazan, Saudi Arabia

Date of Web Publication25-Apr-2019

Correspondence Address:
Dr. Ali Almudeer
Neonatology Department, King Fahad Central Hospital (KFCH), Jazan
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcn.JCN_119_18

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  Abstract 


Background: Jaundice is a yellow discoloration of the skin and sclera resulted from an increased level of bilirubin in the blood. Neonatal morbidity from neonatal jaundice has a huge impact and burden on family and health resources. The majority of cases are resolved with no intervention while some need some assessment and intervention either follow-up or management. Inadequate awareness and understanding of this common neonatal problem by the family can play a role in delays and complications. Aim: The aim of this study is to assess mothers' perception toward neonatal jaundice in Jazan region in Saudi Arabia. Subjects and Methods: Cross-sectional study that was performed through online survey and completed by mothers during the period from July to August 2018. Results: There were 60.4% of mothers had poor knowledge, whereas 39.6% had good knowledge, the most common source of knowledge was physicians (83.8%). Several factors affected the level of mother's knowledge, including age (P = 0.01), education level (P = 0.001), parity (P = 0.002), or history of their infants developed neonatal jaundice (P = 0.009). Conclusion: Mothers who participated in the study showed inadequate and misconception knowledge toward neonatal jaundice, which must be considered to reduce the consequences of this common condition. We advocate for improved maternal knowledge during antenatal follow-up and well-baby clinic visits.

Keywords: Knowledge, mothers, neonatal jaundice


How to cite this article:
Magfouri H, Aqeel A, Maashi A, Maghfuri N, Jarad R, Kathiah AA, Abdu DA, Almudeer A. Mothers' perception of neonatal jaundice in Jazan Region, KSA. J Clin Neonatol 2019;8:116-9

How to cite this URL:
Magfouri H, Aqeel A, Maashi A, Maghfuri N, Jarad R, Kathiah AA, Abdu DA, Almudeer A. Mothers' perception of neonatal jaundice in Jazan Region, KSA. J Clin Neonatol [serial online] 2019 [cited 2019 Sep 19];8:116-9. Available from: http://www.jcnonweb.com/text.asp?2019/8/2/116/257134




  Introduction Top


Jaundice is a yellowish discoloration of the sclera and skin that caused by deposition of bilirubin in tissues.[1] Jaundice is responsible for neonatal morbidity in the world, and it is responsible for 75% of hospital readmission during the 1st week of born,[2] it occurs in 80% of preterm babies and 60% of term neonates.[3] The majority of cases is resolved with no management, but about a few percentages of them can develop severe jaundice.[4] There are two factors lead to the development of jaundice in newborn including the immature liver metabolism pathway and the breakdown of fetal hemoglobin, which leads to the accumulation of bilirubin level in the blood and result in jaundice symptoms. Bilirubin level >5 mg/dl refers to neonatal jaundice.[5] Preterm has higher bilirubin production rate than adults as their red blood cells have a higher rate of hemolysis, shorter life span, undeveloped conjugating system, and inadequate caloric intake.[1],[6],[7] Furthermore, babies who take suboptimal milk intake from breast milk may suffer from jaundice.[8] If the level of bilirubin reaches critical values, it will lead to serious central nervous system disabilities.[9] It will be neurotoxic and cause kernicterus with diffuse neuronal damage.[5] Consequences like cerebral palsy can happen which results in speech, deafness disorders, mental retardation, and learning disabilities.[10] Understanding the nature of jaundice, early detection and bad consequences can help in protect those newborn from jaundice complication. Mothers plays a critical role in their baby life in our culture mainly the 1st day post delivery, as they responsible one for their baby care. Mothers should have enough education and awareness about early identification of jaundice signs and caring of jaundiced baby and this will help in effective management and avoiding complications of jaundice.[11] The study aims to investigate the perception of mothers toward neonate jaundice in our region Jazan.


  Subjects and Methods Top


Subjects and study design

This study is a cross-sectional study that was conducted on mothers in King Fahd Central Hospital, in Jazan region in the period from July to August 2018. The study was performed using an online survey, the survey included two parts, the first part investigated demographics data of the mothers and the second part investigated their knowledge toward neonatal jaundice.

Statistical analysis

Collected data were analyzed using Statistical Package for Social Science (SPSS) version 13 (SPSS Inc., Chicago, Illinois, and USA). The Student's t-test was used to find association between the sociodemographic data of the mothers and their knowledge. Value of P < 0.05 was statistically significant.


  Results Top


During the study period, 450 mothers were participated in the survey with the age range between 20 and 29 years, which represented 62.2% among all participants. Dominant were achieved secondary education (44.4%) and university education (46.7%). Housewives were more dominant (77.8%) than working females (22.2%). Almost three-quarter of participants (75.1%) were multipara and 55.6% reported having the previous child with neonate jaundice [Table 1].
Table 1: Characteristics of participants

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The participant's knowledge showed that 272 (60.4%) had poor knowledge, whereas 78 (39.6%) had good knowledge [Figure 1].
Figure 1: Knowledge about neonatal jaundice among participants

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The knowledge on the causes, managements, and consequences of neonatal jaundice were tested. Maternal knowledge regarding causes of neonatal jaundice was 359 (79.8%) hemolysis, frequent ultrasonography examination during pregnancy 250 (55.6%) and prematurity 245 (54.4%). The most common complication reported by mothers was mental retardation 379 (77.6%) and the most common methods for treatment reported were phototherapy 414 (92%) and neo lamp 376 (83.6%) [Table 2].
Table 2: Causes, complications, and treatment of neonate jaundice as reported by mothers

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The most common source of knowledge was physicians 377 (83.8%), followed by family and friends 43 (9.6%) [Figure 2].
Figure 2: Source of knowledge

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By investigating factors that may be associated with the level of knowledge of mothers, it was clear that the age, education level, parity, and history of neonatal jaundice were significantly influenced the level of knowledge, whereas occupation had no significant impact [Table 3]. Younger mothers with the age group of 20–29 years old (96%) tended to have good knowledge (P = 0.01), higher education from university degree bachelor or higher (89.3%) (P = 0.001), multipara mothers (77.5%) (P = 0.002), and mothers who had previous baby with a history of neonatal jaundice (84.3%) (P = 0.009).
Table 3: Correlation between knowledge and demographics

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  Discussion Top


In the present study, younger mothers with age ranging between 20 and 29 years represent the majority among other participants as well as multipara mothers. The current study showed that there was poor level of knowledge about neonatal jaundice among mothers, whereas 60.4% had poor knowledge and only 39.6% had good knowledge. However, 83.8% reported that their main source of their knowledge was physicians. In another Saudi study performed on parents to assess their knowledge, it was reported by 52.6% of the participants that their source of knowledge was friends and 29.8% reported their source to be the treating doctor.[12] Our results were better than the Egyptian study,[13] which showed 81.1% of mothers had poor knowledge about neonatal jaundice, whereas another study from another area in Egypt showed that there was a moderately good level of knowledge among mothers about neonatal jaundice.[14] A study from Nigeria showed that there was inadequate knowledge and there was a misconception among mothers regarding neonatal jaundice,[10] which is consistent with the study in some maternal perception regard frequent ultrasonography examination of mothers can cause neonatal jaundice which is also mention in the Egyptian study.[13] In the study, the most common causes of neonatal jaundice reported were hemolysis (79.8%), increased US examination during pregnancy (55.6%) and prematurity (54.4%). The most reported complication was mental retardation (77.6%) and several methods of treatment were reported, including phototherapy (922%), neon lamp (83.6%), and drugs (77.6%) compared to the Egyptian study[13] which showed that mental retardation (29.4%) was the most common reported assumed complication of jaundice and regarding the treatment methods, mothers reported that drugs (88.3%), phototherapy (82.3%), and neon lamp (7.7%) as the most treatment strategies, this was consistent with our findings. There were 17.8% of mothers in the Nigerian study reported that exposure to sunlight was a treatment option for neonatal jaundice, and 9.9% correctly answered about the cause of neonate jaundice as prematurity, infection in baby and blood incompatibility between mothers and baby.[10] In another study from Iran mothers reported that 43.2% and 18.5% infection in blood and prematurity, respectively, were the major assumed causes of neonatal jaundice, 44.5% and 29.7% neonatal death and retardation, respectively, were the assumed consequences of neonatal jaundice, whereas 38.5% of mothers mentioned phototherapy and 2.75% told blood exchange is the possible treatment.[15] The present study showed that age, education, parity of mothers, and history of having baby with neonatal jaundice significantly affected the level of knowledge. Another study from Egypt reported that working mothers had significantly more knowledge,[14] which we could not prove it in our study findings, as it had no influence on the level of mother knowledge. Some other studies showed more deficient maternal knowledge about neonatal jaundice as showed up in one of the Egyptian studies[14] as one had been conducted in Turkey[16] regarding the evaluation of maternal knowledge level about neonatal jaundice. They concluded that the mothers' knowledge about neonatal jaundice is insufficient. Maternal education level and having a previous offspring with jaundice are major factors affecting the knowledge of the mothers on hyperbilirubinemia. The knowledge needs to be improved in those mothers but is not sufficient to change such behavior. The health-care provider can influence mothers' perception and hence, we advocate for more work on following antenatal and well-baby clinics visits to improve such perception.


  Conclusion Top


Mothers who participated in the study showed inadequate and misconception knowledge toward neonatal jaundice, which must be considered to reduce the consequences of this common condition. We advocate for improved maternal knowledge during antenatal follow up and well-baby clinic visits.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics 2004;114:297-316.  Back to cited text no. 1
    
2.
Egube BA, Ofili AN, Isara AR, Onakewhor JU. Neonatal jaundice and its management: Knowledge, attitude, and practice among expectant mothers attending antenatal clinic at university of Benin teaching hospital, Benin city, Nigeria. Niger J Clin Pract 2013;16:188-94.  Back to cited text no. 2
  [Full text]  
3.
Cooray G. The knowledge, attitude and behavior on neonatal jaundice of postnatal. Sri Lanka J Child Health 2011;40:164-8.  Back to cited text no. 3
    
4.
Smitherman H, Stark AR, Bhutani VK. Early recognition of neonatal hyperbilirubinemia and its emergent management. Semin Fetal Neonatal Med 2006;11:214-24.  Back to cited text no. 4
    
5.
Dash MA. Descriptive study to assess the knowledge and attitude on neonatal jaundice among the mothers in a selected village of Puducherry. J Med Health Sci 2013;2:41-6.  Back to cited text no. 5
    
6.
Stoll BJ, Kliegman RM. Jaundice and hyperbilirubinaemia in the newborn. In: Behrman RE, Kliegman RM, Jenson HB, editors. Nelson Textbook of Pediatrics. Philadelphia: W. B. Saunders Company; 2005. p. 513-9.  Back to cited text no. 6
    
7.
Olusanya BO, Emokpae AA, Zamora TG, Slusher TM. Addressing the burden of neonatal hyperbilirubinaemia in countries with significant glucose-6-phosphate dehydrogenase deficiency. Acta Paediatr 2014;103:1102-9.  Back to cited text no. 7
    
8.
Blackmon LR, Fanaroff AA, Raju TN; National Institute of Child Health and Human Development. Research on prevention of bilirubin-induced brain injury and kernicterus: National Institute of Child Health and Human Development conference executive summary 2003. Pediatrics 2004;114:229-33.  Back to cited text no. 8
    
9.
Zupan J. Perinatal mortality in developing countries. N Engl J Med 2005;352:2047-8.  Back to cited text no. 9
    
10.
Ezeaka VC, Ekure EN, Fajolu IB, Ezenwa BN, Akintan PE. Mothers' perception of neonatal jaundice in Lagos, Nigeria: An urgent need for greater awareness. S Afr J Child Health 2016;10:227-30.  Back to cited text no. 10
    
11.
Wadha N, Sibal A. An approach to neonatal direct hyperbilirubinemia. Paediatr Today 2006;9:303-7.  Back to cited text no. 11
    
12.
Alfouwais NM, Seada LS, Alahmadi RY, Alassiri AA, Alenazi AA, Aljuaeed MS. Assessment of knowledge, attitude and practice of Saudi parents towards neonatal jaundice (NNJ): A cross-sectional study. Egypt J Hosp Med 2018;70.  Back to cited text no. 12
    
13.
Allahony DM, Hegazy NN, Kasemy ZA, Bahgat EM. Mothers' perception toward neonatal jaundice in Kafr El-batanoon village, Menoufia, Egypt. Menoufia Med J 2016;29:743.  Back to cited text no. 13
  [Full text]  
14.
Moawad EM, Abdallah EA, Ali YZ. Perceptions, practices, and traditional beliefs related to neonatal jaundice among Egyptian mothers: A cross-sectional descriptive study. Medicine (Baltimore) 2016;95:e4804.  Back to cited text no. 14
    
15.
Khalesi N, Rakhshani F. Knowledge, attitude and behaviour of mothers on neonatal jaundice. J Pak Med Assoc 2008;58:671-4.  Back to cited text no. 15
    
16.
Sumer S. Evaluation of maternal knowledge level about neonatal jaundice. J Matern Fetal Neonatal Med 2012;25:212.  Back to cited text no. 16
    


    Figures

  [Figure 1], [Figure 2]
 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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Abstract
Introduction
Subjects and Methods
Results
Discussion
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