Incidence, aetiology and short term outcomes of extreme hyperbilirubinaemia, in term infants born in the Western health subdistrict of Cape Town, South Africa between 2019 and 2020.

This article focuses on the incidence, causes, and short-term outcomes of extreme hyperbilirubinaemia in term newborns in the Western health subdistrict of Cape Town, South Africa. In this retrospective study of infants with serum bilirubin levels ≥430 μmol/L within the first week of life, the incidence was found to be 74 cases per 100,000 live births, higher than rates reported in high-income countries. The most common causes identified were ABO blood group incompatibility and glucose-6-phosphate dehydrogenase (G6PD) deficiency. Most affected infants required readmission after initial discharge, with 20% undergoing exchange transfusions and some exhibiting neurological symptoms such as encephalopathy. The study highlights the need for improved early detection through healthcare worker training and caregiver education to prevent bilirubin-induced neurological complications in resource-limited settings.