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Последний просмотренный: 26 Nov 2025
Last updated: 21 Nov 2023

Резюме

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • cephalocaudal progression
  • decreasing gestational age
  • male
  • family history of jaundice
  • family history of anemia
  • family history of splenectomy
  • maternal exposure to sulfonamides or antimalarials
  • hepatosplenomegaly
  • microcephaly
  • chorioretinitis
  • small for gestational age
  • cephalhematoma
  • hypertonia
  • high-pitched cry
  • retrocollis
  • opisthotonus
Full details

Other diagnostic factors

  • perinatal asphyxia
  • macrosomia
  • plethora
  • hypotonia
  • lethargy
Full details

Risk factors

  • Asian
  • American-Indian
  • maternal diabetes
  • oxytocin in labor
  • low birth weight
  • decreased gestational age
  • decreased caloric intake and weight loss
  • breast-feeding
  • delayed cord clamping (2 to 3 minutes)
  • genetic factors
Full details

Diagnostic tests

1st tests to order

  • transcutaneous bilirubin (TcB)
  • total serum bilirubin
  • direct Coombs test
  • direct serum bilirubin
Full details

Tests to consider

  • hematocrit
  • CBC
  • reticulocyte count
  • peripheral blood smear
  • blood groups
  • glucose-6-phosphate dehydrogenase (G6PD) screening
  • osmotic fragility test
  • blood culture
  • liver function tests
  • urine for reducing substances
  • plasma amino acids
  • urine organic acids
  • urine culture
  • abdominal ultrasound
  • percutaneous liver biopsy
Full details

Treatment algorithm

ACUTE

physiologic hyperbilirubinemia

pathologic hyperbilirubinemia: unconjugated

pathologic hyperbilirubinemia: conjugated

breast-feeding/breast milk jaundice

Contributors

Authors

Vineet Bhandari, MBBS, MD, DM
Vineet Bhandari

Division Head, Neonatology

Vice Chair, Faculty Development

Department of Pediatrics

The Children's Regional Hospital at Cooper

Professor of Pediatrics, Obstetrics and Gynecology and Biomedical Sciences

Cooper Medical School of Rowan University

Camden

NJ

Disclosures

VB declares that he has no competing interests.

Peer reviewers

Rima Fawaz, MD

Associate Professor of Pediatrics

Medical Director, Pediatric Hepatology and Pediatric Liver Transplantation

Yale University School of Medicine

New Haven

CT

Disclosures

RF declares that she has no competing interests.

Alex Kemper, MD, MPH, MS

Professor of Pediatrics

Division Chief of Primary Care Pediatrics

Nationwide Children's Hospital

Columbus

OH

Disclosures

AK declares that he has no competing interests.

Helen McElroy, MBChB, MRCPI, MSc

Consultant Neonatologist

Neonatology

Medway Maritime Hospital

Gillingham

UK

Divulgaciones

HM declares that she has no competing interests.

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Referencias

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Artículos principales

Kemper AR, Newman TB, Slaughter JL, et al. Clinical practice guideline revision: management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2022 Sep 1;150(3):e2022058859.Texto completo

Woodgate P, Jardine LA. Neonatal jaundice: phototherapy. BMJ Clin Evid. 2015 May 22;2015:0319.Texto completo  Resumen

Slaughter JL, Kemper AR, Newman TB. Technical report: Diagnosis and management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2022 Sep 1;150(3):e2022058865.Texto completo  Resumen

Gu J, Zhu Y, Zhao J. The efficacy of intravenous fluid supplementation for neonatal hyperbilirubinemia: a meta-analysis of randomized controlled studies. J Matern Fetal Neonatal Med. 2019 Nov 17;1-6. Resumen

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
  • Guías de práctica clínica

    • Phototherapy to prevent severe neonatal hyperbilirubinemia in the newborn infant 35 or more weeks of gestation: technical report
    • Technical report: Diagnosis and management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation
    Más Guías de práctica clínica
  • Folletos para el paciente

    Jaundice in newborn babies: what is it?

    Jaundice in newborn babies: what are the treatment options?

    Más Folletos para el paciente
  • padlock-lockedInicie sesión o suscríbase para acceder a todo el BMJ Best Practice

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