Usually noted clinically when serum bilirubin is >5 mg/dL. Occurs in 60% to 70% of term neonates. Most cases physiologic.
Jaundice in the first 24 hours of life is considered pathologic.
Treatment for severe hyperbilirubinemia includes phototherapy and/or exchange transfusion.
The major complication of unconjugated hyperbilirubinemia is kernicterus.
Neonatal jaundice is the yellowing discoloration of the skin and sclera of a neonate, which is caused by increased levels of bilirubin in the blood. A neonate refers to an infant in the first 28 days of life.
This topic focuses on recognizing and managing early neonatal jaundice, which is most commonly caused by unconjugated hyperbilirubinemia. While prolonged jaundice with conjugated hyperbilirubinemia may present during this period, appropriate management depends on the pathologic cause and detailed commentary is beyond the scope of this material.
History and exam
- presence of risk factors
- cephalocaudal progression
- decreasing gestational age
- family history of jaundice
- family history of anemia
- family history of splenectomy
- maternal exposure to sulfonamides or antimalarials
- small for gestational age
- high-pitched cry
Vineet Bhandari, MBBS, MD, DM
Professor of Pediatrics Obstetrics and Gynecology
Drexel University College of Medicine
Chief, Section of Neonatal Medicine
St. Christopher's Hospital for Children/Hahnemann University Hospital/Temple University Hospital
VB declares that he has no competing interests.
Gautham K. Suresh, MD, DM, MS
Professor of Pediatrics
Baylor College of Medicine
Section Head and Service Chief of Neonatology
Texas Children's Hospital
GKS declares that he has no competing interests.
Helen McElroy, MBChB, MRCPI, MSc
Medway Maritime Hospital
HM declares that she has no competing interests.
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