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Jaundice in the Newborn

  • Warren Rosenfeld
Chapter

Abstract

Jaundice in the newborn is one of the most common clinical issues encountered by providers in the nursery. While neonatal jaundice is a normal physiologic event, it may at times reach levels that can cause long-term and permanent sequelae. Recognition of the risk factors for hyperbilirubinemia, timely management and monitoring of jaundice, and the correct treatment decisions will help to prevent these sequelae. Management of jaundice in the nursery is also complicated by the need to predict the level of bilirubin not only in the nursery but also after discharge. This chapter will discuss risk factors for jaundice, screening tools, and management of patients who develop jaundice.

Keywords

Jaundice Hyperbilirubinemia Phototherapy Bilirubin 

References

  1. 1.
    Keren R, Tremont K, Luan X, Cnaan A. Visual assessment of jaundice in term and late preterm infants. Arch Dis Child Fetal Neonatal El. 2009;94:F317–22.CrossRefGoogle Scholar
  2. 2.
    Bhutani VK, Stark AR, Lazzeroni LC, Poland R, Gourly GR, Kazmierczak S, et al. Predischarge screening for severe hyperbilirubinemia identifies infants who need phototherapy. J Pediatr. 2013;162:477–82.e1.CrossRefGoogle Scholar
  3. 3.
    Watchko JF, Tiribelli C. Bilirubin induced neurologic damage: mechanisms and management approaches. N Engl J Med. 2013;369:2021.CrossRefGoogle Scholar
  4. 4.
    Kramer LI. Advancement of dermal icterus in the jaundiced newborn. Amer J Dis Child. 1969;118:454.PubMedGoogle Scholar
  5. 5.
    Moyer VA, Ahn C, Sneed S. Accuracy of clinical judgment in neonatal jaundice. Arch Pediatr Adolesc Med. 2000;154:391.CrossRefGoogle Scholar
  6. 6.
    Tayaba R, Gribetz D, Gribetz D, Holzman IR. Noninvasive estimation of serum bilirubin. Pediatrics. 1998;102:E28.CrossRefGoogle Scholar
  7. 7.
    Engle W, Jackson GL, Engle NG. Transcutaneous bilirubinometry. Semin Perinat. 2014;38:438.CrossRefGoogle Scholar
  8. 8.
    Rubaltelli FF, Gourley GR, Loskamp N, Modi N, Roth-Kleiner M, Sender A, Vert P. Transcutaneous bilirubin measurement: a multicenter evaluation of a new device. Pediatrics. 2001;107:1264.CrossRefGoogle Scholar
  9. 9.
    Taylor JA, Burgos AE, Flaherman V, Chung E, Simpson EA, Goyal NK, Von Kohorn I, Dhepyasuwan N, The Better Outcomes Through Research Network. Discrepancies between transcutaneous and serum bilirubin measurements. Pediatrics. 2015;135:224.  https://doi.org/10.1542/peds.2014-1919.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Bhutani VK, Johnson L, Sivieri MS. Predictive ability of a pre-discharge serum bilirubin for subsequent significant hyperbilirubinemia in healthy term and near-term newborns. Pediatrics. 1999;103:6.CrossRefGoogle Scholar
  11. 11.
    Bromiker R, Bin-Nun A, Schimmel MS, Hammerman C, Kaplan M. Neonatal hyperbilirubinemia in the low-intermediate-risk category on the bilirubin nomogram. Pediatrics. 2012;130:e470.  https://doi.org/10.1542/peds.2012-0005.CrossRefPubMedGoogle Scholar
  12. 12.
    Slaughter J, Annibale D, Suresh G. False-negative results of pre-discharge bilirubin screening to predict severe hyperbilirubinemia: a need for caution. Eur J Pediatr. 2009;168:1461.CrossRefGoogle Scholar
  13. 13.
    American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2004;114:297.  https://doi.org/10.1542/peds.114.1.297.CrossRefGoogle Scholar
  14. 14.
    Maisels MJ, Bhutani VK, Bogen D, Newman TB, Ar S, Watchko JF. Hyperbilirubinemia in the newborn infant ≥35 weeks’ gestation: an update with clarification. Pediatrics. 2009;124:1193.  https://doi.org/10.1542/peds.2009-0329.CrossRefPubMedGoogle Scholar
  15. 15.
    Longhurst C, Turner S, Burgos AE. Development of a web-based decision support tool to increase use of neonatal hyperbilirubinemia guidelines. Jt Comm J Qual Patient Saf. 2009;35:256.CrossRefGoogle Scholar
  16. 16.
    Christensen T, Reitan JB, Kinn G. Single-strand breaks in the DNA of human cells exposed to visible light from phototherapy lamps in the presence and absence of bilirubin. J Photochem Photobiol B. 1990;7:337.CrossRefGoogle Scholar
  17. 17.
    Csoma Z, Toth-Molnar E, Balogh K, et al. Neonatal blue light phototherapy and melanocytic nevi: a twin study. Pediatrics. 2011;128:e856.CrossRefGoogle Scholar
  18. 18.
    Newman TB, Wickeremasinghe C, Walsh EM, Grimes BA, McCulloch CE, Kuzniewicz MW. Retrospective cohort study of phototherapy and childhood cancer in Northern California. Pediatrics. 2016;137:1.CrossRefGoogle Scholar
  19. 19.
    Maisels MJ. Managing the jaundiced newborn. A persistent challenge. CMAJ. 2015;187:335.CrossRefGoogle Scholar
  20. 20.
    Martinez JC, Otheguy L, Garcia H, Savorani M, Mogni B, Martinez JC Jr, Maisels MJ. Hyperbilirubinemia in the breast-fed newborn: a control trial of four interventions. Pediatrics. 1993;91:470.PubMedGoogle Scholar
  21. 21.
    Barak M, Berger I, Dollberg S, Mimouni FB, Mandel D. When should phototherapy be stopped? A pilot study comparing two targets of serum bilirubin concentrations. Acta Paediatri. 2009;98:277.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of PediatricsSUNY/Stony Brook School of MedicineStony BrookUSA
  2. 2.Department of PediatricsMount Sinai - South Nassau Medical CenterOceansideUSA

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