Abstract
Phototherapy is the preferred treatment for neonatal hyperbilirubinemia and has largely replaced exchange transfusions due to its effectiveness and safety. The primary aim of this study was to evaluate the time to recovery and its predictors among neonates undergoing phototherapy at the Neonatal Intensive Care Unit of the Northwest Comprehensive Specialized Hospital in Northwest Ethiopia. A multi-center institution-based retrospective follow-up study was conducted among 423 neonates admitted to the neonatal intensive care unit between September 2019 and December 2023, at Comprehensive Specialized Hospitals of Northwest Ethiopia. Simple random sampling techniques were used to select neonates. Data were entered into the EPI Data version 4.6.0.2 and exported to STATA 14 statistical software for analysis. The Kaplan-Meier failure curve was used to estimate the time to recovery from phototherapy. During follow-up, statistical differences between variables were compared using the log-rank test. After testing the goodness of fit of the final model, multi-variable Cox proportional hazard regression was used to identify predictors of recovery time from phototherapy. Variables with a p-value less than 0.05 were considered statistically significant. In total 423 neonates were included in this study. Of these, 68.79% (n = 291) achieved successful clinical recovery, with a median survival time of 3 days. Predictors affecting recovery time were Rh-setup (AHR: 0.63; 95% CI: (0.45-0.86) sepsis (AHR: 0.55; 95% CI: (0.33-0.91), ABO-setup (AHR: 0.59; 95%CI: (0.46-0.79), sex (AHR: 0.70; 95% CI (0.55-0.91), and inadequate feeding (AHR: 0.56; 95% CI: (0.33-0.92) which delayed recovery time. In the current study, the median time to recovery after phototherapy was prolonged compared to as a clinical recommendation. Rh setup, ABO setup, sepsis, poor feeding, and male sex were all predictive factors of delayed recovery time.