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Neonatal jaundice

Última revisão: 28 Sep 2025
Última atualização: 21 Nov 2023

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • 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
Detalhes completos

Outros fatores diagnósticos

  • perinatal asphyxia
  • macrosomia
  • plethora
  • hypotonia
  • lethargy
Detalhes completos

Fatores de risco

  • 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
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • transcutaneous bilirubin (TcB)
  • total serum bilirubin
  • direct Coombs test
  • direct serum bilirubin
Detalhes completos

Investigações a serem consideradas

  • 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
Detalhes completos

Algoritmo de tratamento

AGUDA

physiologic hyperbilirubinemia

pathologic hyperbilirubinemia: unconjugated

pathologic hyperbilirubinemia: conjugated

breast-feeding/breast milk jaundice

Colaboradores

Autores

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

Declarações

VB declares that he has no competing interests.

Revisores

Rima Fawaz, MD

Associate Professor of Pediatrics

Medical Director, Pediatric Hepatology and Pediatric Liver Transplantation

Yale University School of Medicine

New Haven

CT

Declarações

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

Declarações

AK declares that he has no competing interests.

Helen McElroy, MBChB, MRCPI, MSc

Consultant Neonatologist

Neonatology

Medway Maritime Hospital

Gillingham

UK

Declarações

HM declares that she has no competing interests.

Créditos aos pareceristas

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Declarações

As afiliações e declarações dos pareceristas referem--se ao momento da revisão.

Referências

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Principais artigos

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  Resumo

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  Resumo

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. Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Diretrizes

    • 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
    Mais Diretrizes
  • Folhetos informativos para os pacientes

    Jaundice in newborn babies: what is it?

    Jaundice in newborn babies: what are the treatment options?

    Mais Folhetos informativos para os pacientes
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