Bilirubin is one of liver function tests
What is neonatal hyperbilirubinemia?
Neonatal hyperbilirubinemia is a condition where there is too much bilirubin in a newborn’s blood, causing a yellow discoloration of the skin and eyes.
What causes neonatal hyperbilirubinemia?
It can be caused by several factors including physiological jaundice, breastfeeding failure, breastmilk jaundice, jaundice from hemolysis, and jaundice caused by poor liver function.
What is the normal bilirubin level in neonates?
Jaundice usually becomes visible on the sclera at a level of 2 to 3 mg/dL (34 to 51 micromol/L) and on the face at about 4 to 5 mg/dL (68 to 86 micromol/L).
When does jaundice appear in neonates?
Slightly more than half of all neonates become visibly jaundiced in the first week of life.
What is the threshold for concern for bilirubin levels in healthy term infants?
Among healthy term infants, the threshold for concern typically is considered to be a level > 18 mg/dL (> 308 micromol/L).
What is the threshold for concern for bilirubin levels in preterm infants?
A bilirubin concentration > 10 mg/dL (> 171 micromol/L) in preterm infants warrants additional testing.
What tests are done when bilirubin levels are high?
Additional testing may include hematocrit, blood smear, reticulocyte count, direct Coombs test, total serum bilirubin and direct bilirubin1.
What is the risk of high bilirubin levels in neonates?
High bilirubin concentrations can cause acute bilirubin encephalopathy and kernicterus, a permanent disabling neurologic condition3.
What are the symptoms of kernicterus?
Kernicterus is characterized by choreoathetoid cerebral palsy, upward gaze paresis, enamel dysplasia of deciduous teeth, sensorineural hearing loss or auditory neuropathy or dyssynchrony spectrum disorder, and characteristic findings on brain MRI3.
What is the treatment for high bilirubin levels in neonates?
Treatment options include phototherapy and exchange transfusion.
What percentage of full-term newborns get jaundice?
About 60% of full-term newborns get jaundice.
What percentage of premature babies get jaundice?
About 80% of premature babies get jaundice.
What is physiological jaundice?
Physiological jaundice happens as a response to a baby’s reduced ability to remove bilirubin.
What is breastfeeding failure jaundice?
Some babies don’t breastfeed well at first, which can lead to jaundice.
What is breastmilk jaundice?
About 2% of breastfed babies get jaundice.
What is jaundice from hemolysis?
Jaundice from hemolysis is a type of jaundice that occurs when red blood cells break down at a fast rate.
What is jaundice caused by poor liver function?
Jaundice caused by poor liver function occurs when the liver is unable to properly process bilirubin.
What is the major consequence of neonatal hyperbilirubinemia?
Neurotoxicity is the major consequence of neonatal hyperbilirubinemia.
What is the risk of hyperbilirubinemia in neonates?
Risk of hyperbilirubinemia is based on age-specific total serum bilirubin levels.
What is the treatment for neonatal hyperbilirubinemia?
The treatment for neonatal hyperbilirubinemia includes phototherapy and exchange transfusion
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