**3. Conclusions**

*Update on Critical Issues on Infant and Neonatal Care*

**Groups Descriptive statistics**

Unspecified 126 165.36 ± 26.5 105–224

Unspecified 126 4.67 ± 0.6 3.27–6.58

Unspecified 126 44.26 ± 7.2 28.4–64.6

**Groups Descriptive statistics**

Unspecified 126 11.94 ± 7.4 11.0 1–39

Unspecified 126 4.02 ± 2.5 3.0 2–14

Unspecified 126 15.03 ± 25.7 9.0 2–279

ABO/Rh 41 27.88 ± 26.4 22.0 2–121 *Z* = 4.13

ABO/Rh 41 2.63 ± 2.4 2.0 1–14 *Z* = 5.78

ABO/Rh 41 379.76 ± 133.5 364.0 158–801 *Z* = 1.95 *<sup>p</sup>* = 0.052 NS Unspecified <sup>126</sup> 333.44 ± 91.1 324.0 107–598

ABO/Rh 41 10.22 ± 9.02 6.0 1–37 *Z* = 2.09

ABO/Rh 40 274.2 ± 124.9 235.5 96–682 *Z* = 1.87 *<sup>p</sup>* = 0.062 NS Unspecified <sup>112</sup> 227.39 ± 80.7 211.5 60–473

ABO/Rh 24 227.46 ± 83.4 206.0 111–437 *Z* = 0.76 *<sup>p</sup>* = 0.448 NS Unspecified <sup>48</sup> 221.92 ± 48.3 228.5 51–314

*Z, (Mann-Whitney U test); N, number of patients; SD, standard deviation; p, probability value; NS, not significant.* 

*Reticulocytes and bilirubin analyses in neonatal jaundice, comparison between ABO/Rh incompatibility and* 

*N* **Mean ± SD Median Min-max** *t***-value,** *p*

*N* **Mean ± SD Min-max** *t***-value,** *p*

ABO/Rh 41 155.02 ± 30.3 74–218 *t* = 2.09 *p* = 0.038\*

ABO/Rh 41 4.29 ± 0.8 2.05–5.81 *t* = 3.09 *p* = 0.0023\*

ABO/Rh 41 41.35 ± 8.9 18.9–61.9 *t* = 2.11 *p* = 0.037\*

*t, student t-test; N, number of patients; SD, standard deviation; p, probability value. Information from Ref. [38].*

*Hematological parameters in neonatal jaundice, comparison between ABO/Rh incompatibility and unspecified* 

*p* = 0.000036\*\*

*p* = 0.000\*\*

*p* = 0.036\*

**12**

**Table 5.**

*\* p < 0.05. \*\*p < 0.01.*

Ret

Hb (g/L)

Er (×1012)

Hct (%)

*\* p < 0.05.*

**Table 4.**

*etiology groups.*

Day of bilirubin peak

Peak bilirubin level (μmol/L)

Duration of the bilirubin peak (days)

First control bilirubin (μmol/L)

Second control bilirubin (μmol/L)

*Information from Ref. [38].*

*unspecified etiology groups.*

Neonatal indirect hyperbilirubinemia is a common phenomenon during the first week of postnatal life affecting almost two thirds of term newborns. The mechanism of neonatal jaundice is multifactorial, involving delicate balance between processes that potentiate bilirubin production and the ones that diminish bilirubin clearance. Although etiology of jaundice has been widely studied, identification of pathological causes presents constant clinical challenge.

Hyperbilirubinemia was found to be a common clinical presentation at the neonatology department of the University Pediatric Clinic in Skopje, Republic of North Macedonia, and encompassing one quarter of the hospitalized patients. Most cases suffered from a less severe jaundice of undefined etiology that had tendency to longer duration. Almost 15% of the hyperbilirubinemia cases presented with hemolytic causes of jaundice that had earlier and more severe peak of the bilirubin level. Those required immediate clinicians' attention and prompt management plan and were candidates for subsequent neurodevelopmental follow-up.
