Materiały źródłowe

• #1 Narrative review of the epidemiology of neonatal jaundice – Hansen – Pediatric Medicine

  https://pm.amegroups.org/article/view/6073/html

  Neonatal jaundice (NJ) is one of the most common causes for medical intervention in the newborn period. […] Thus, jaundice in the newborn has a reported incidence between 60% to more than 90%. […] An increased incidence is seen in infants of Southeast Asian mothers, while African infants have a lower incidence unless they suffer from G-6-PD-deficiency. […] Extreme NJ, associated with risk of kernicterus spectrum syndrome, has an estimated worldwide incidence of 99/100,000 or more, thus affecting 130,000 or more infants each year and calling for increased vigilance and preparedness for rapid therapeutic intervention. […] The majority of newborn infants are judged to have NJ at some point during their first days of life, but the reported data for occurrence vary from 60% to nearly 100%, and are often not comparable because methods and criteria vary between studies.

• #2 The epidemiology of neonatal jaundice.

  https://www.duo.uio.no/handle/10852/90448

  The epidemiology of neonatal jaundice. […] Neonatal jaundice (NJ) is one of the most common causes for medical intervention in the newborn period. […] Thus, jaundice in the newborn has a reported incidence between 60% to more than 90%. […] A family history of NJ increases the likelihood of jaundice in the present newborn, and is one of several examples of genetic conditions that contribute. […] An increased incidence is seen in infants of Southeast Asian mothers, while African infants have a lower incidence unless they suffer from G-6-PD-deficiency. […] Preterm infants have immature bilirubin metabolism and a higher incidence of jaundice. […] Breast-fed infants have an increased incidence of jaundice, which may also last longer. […] Extreme NJ, associated with risk of kernicterus spectrum syndrome, has an estimated worldwide incidence of 99/100,000 or more, thus affecting 130,000 or more infants each year and calling for increased vigilance and preparedness for rapid therapeutic intervention.

• #3 Neonatal Jaundice

  https://patient.info/doctor/neonatal-jaundice-pro

  Approximately 60% of term and 80% of preterm babies develop jaundice in the first week of life; about 10% of breastfed babies are still jaundiced at 1 month of age. […] The risk of developing significant neonatal jaundice is increased in: Low birth weight: premature and small for dates. […] Jaundice presenting in the first 24 hours of life is more likely to have a serious underlying cause such as infection, haemolytic disease or metabolic disorder. Any baby presenting with jaundice in the first 24 hours of life should therefore be seen urgently for assessment in hospital.

• #4 Neonatal Jaundice – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK532930/

  Unconjugated hyperbilirubinemia is frequently encountered in the neonatal period. About 80% of term and preterm newborns will present with clinical jaundice with a TSB 5 mg/dL. However, only approximately 10% of neonates require phototherapy. Physiologic jaundice is the most frequent cause of clinical jaundice after the first day of life, estimated to account for 50% of cases. Approximately 15% of breastfed infants will develop physiologic UHB lasting 3 weeks. […] Only a minority of jaundiced newborns have pathologic hyperbilirubinemia. Severe hyperbilirubinemia, commonly defined as a TSB25 mg/dL, occurs in approximately 1 out of 2500 live births. Among these, ABO incompatibility, followed by G6PD deficiency, is the most frequently identified cause. Newborns with Southeast and East Asian ancestry have higher recorded TSB levels than Black or White infants. Neonatal jaundice also appears more common in infants living at high altitudes and around the Mediterranean Sea, especially in Greece.

• #5 Guidelines for detection and management of hyperbilirubinemia in term and late preterm newborns (≥35 weeks gestational age) | Canadian Paediatric Society

  https://cps.ca/documents/position/hyperbilirubinemia-newborns

  Approximately 10% of term and preterm newborns have a clinically significant elevation of total serum bilirubin (TSB) levels requiring close surveillance or treatment. […] Standardization of screening and management strategies has significantly decreased the incidence of severe neonatal hyperbilirubinemia, defined as a peak TSB 425 mol/L or need for a blood exchange transfusion (BET). Following the publication of the 2007 Canadian Paediatric Society (CPS) position statement, the Canadian Paediatric Surveillance Program (CPSP) reported a more than threefold decline in the incidence of severe hyperbilirubinemia. […] However, kernicterus continues to be reported in North America and Europe, and hyperbilirubinemia requiring treatment is still the predominant reason for hospital readmissions of newborns in North America.

• #5 Guidelines for detection and management of hyperbilirubinemia in term and late preterm newborns (≥35 weeks gestational age) | Canadian Paediatric Society

  https://cps.ca/documents/position/hyperbilirubinemia-newborns

  The goal of universal screening is to identify newborn infants at risk for developing hyperbilirubinemia. […] The AAP and CPS have previously recommended screening all healthy newborns with a timed TSB between 18 to 72 hours of age and plotting the result on a predictive nomogram to facilitate post-discharge follow-up. […] Two categories of jaundice risk factors have been described, with some overlap between them. Hyperbilirubinemia risk factors increase baseline risk of a neonate developing this condition, while neurotoxicity risk factors increase the toxic effects of bilirubin on the newborn brain. […] While knowing that hyperbilirubinemia risk factors are present during the care of a newborn is important, only the neurotoxicity risk factors are incorporated into the phototherapy and exchange transfusion thresholds.

• #6 Neonatal Jaundice: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/974786-overview

  In some LMICs, the incidence of severe neonatal jaundice may be as much as 100 times higher than that in higher-income countries. […] Studies seem to suggest that some of the ethnic variability in the incidence and severity of neonatal jaundice may be related to differences in the distribution of the genetic variants in bilirubin metabolism, previously discussed above. […] The incidence of neonatal jaundice is increased in infants of East Asian, American Indian, and Greek descent, although the latter appears to apply only to infants born in Greece and thus may be environmental rather than ethnic in origin. […] For this reason, significant jaundice in an African infant merits a closer evaluation of possible causes, including G6PD deficiency. […] Male infants are at higher risk of developing significant neonatal jaundice. […] The risk of significant neonatal jaundice is inversely proportional to gestational age.

• #7 Narrative review of the epidemiology of neonatal jaundice – Hansen – Pediatric Medicine

  https://pm.amegroups.org/article/view/6073/html

  The incidence of severe NJ, defined as jaundice associated with acute bilirubin encephalopathy (ABE)/kernicterus and/or exchange transfusions (ET) and/or jaundice-related death, has been estimated by Slusher et al. to be 99/100,000 live births. […] Applying even the moderate estimate of severe NJ from Slusher et al. to the 130 million births per year in the world translates into ~130,000 newborn infants each year who are exposed to significant risk of bilirubin-induced brain damage or death.

• #8 Neonatal Jaundice – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK532930/

  Acute bilirubin encephalopathy occurs at a rate of approximately 1 in 10,000 live births, and the incidence of chronic bilirubin encephalopathy is comparitively lower, estimated at 1 in 50,000 to 100,000 live births. However, developing nations report higher rates of kernicterus, a permanent neurologic condition. […] Conjugated hyperbilirubinemia is much less common than UHB, with an incidence of around 1 in 2500 term infants. The most frequently identified cause of cholestatic jaundice in the neonatal period is biliary atresia, accounting for an estimated 25% to 40% of all cases, followed by infections and PN-induced cholestasis. Approximately 60% to 70% of patients with BA will require liver transplantation in childhood, remaining the most common indication for a pediatric liver transplant.

• #9 Severe hyperbilirubinaemia and kernicterus: more caution is needed in newborn jaundice surveillance.

  https://www.lenus.ie/hse/handle/10147/207720

  Severe hyperbilirubinaemia and kernicterus: more caution is needed in newborn jaundice surveillance. […] Since the 1990s, there has been a re-emergence of cases of severe hyperbilirubinaemia and kernicterus. The current UK incidence of bilirubin encephalopathy is 0.9/100,000 with a higher reported incidence in some countries. […] Some of the current challenges in newborn jaundice surveillance are highlighted.

• #10 Global Prevalence of Severe Neonatal Jaundice among Hospital Admissions: A Systematic Review and Meta-Analysis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10253859/

  Evidence regarding the adverse burden of severe neonatal jaundice (SNJ) in hospitalized neonates in resource-constrained settings is sparse. […] The global burden of SNJ in hospitalized neonates remains high, causing substantial, preventable morbidity and mortality especially in LMICs. […] The prevalence of SNJ among all admitted neonates varied across WHO regions, ranging from 0.73 to 3.34%. […] Among all neonatal admissions, SNJ clinical outcome markers for EBT ranged from 0.74 to 3.81%, with the highest percentage observed in the African and South-East Asian regions; ABE ranged from 0.16 to 2.75%, with the highest percentages observed in the African and Eastern Mediterranean regions; and jaundice-related deaths ranged from 0 to 1.49%, with the highest percentage observed in the African and Eastern Mediterranean regions.

• #11 Neonatal Jaundice: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/974786-overview

  An estimated 50% of term and 80% of preterm infants develop jaundice, typically 2-4 days after birth. […] Neonatal hyperbilirubinemia is extremely common, because almost every newborn develops an unconjugated serum bilirubin level of more than 30 mol/L (1.8 mg/dL) during the first week of life. […] Incidence figures are difficult to compare because authors of different studies do not use the same definitions for significant neonatal hyperbilirubinemia or jaundice. […] The international incidence varies with ethnicity and geography. […] There is a higher incidence in East Asians and American Indians and a lower one in Africans. […] Greeks living in Greece have a higher incidence than those of Greek descent living outside of Greece. […] There is also a higher incidence in populations living at high altitudes.

• #12 Global Prevalence of Severe Neonatal Jaundice among Hospital Admissions: A Systematic Review and Meta-Analysis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10253859/

  The prevalence of SNJ among this cohort ranged between 8.3% and 31.4%, with the highest burden of disease in the Western Pacific and African regions. […] The current review highlights that NNJ is noted in 21.99% of all neonatal admissions across WHO regions in the studies included in our review, consistent with prior studies. […] Striking differences persist between WHO regions for individual SNJ markers again with wide ranges for both ABE and percentages of neonates requiring EBTs. […] The highest proportion of jaundice-related deaths among all neonates was 1.49% in the African region. […] Our study also looked at other factors potentially associated with SNJ. […] The actual burden is likely underreported as many neonates do not reach tertiary centers in LMICs. […] This review also reported a higher prevalence of SNJ in higher-tier health facilities when compared to primary and secondary health facilities.

• #13 Neonatal jaundice epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Neonatal_jaundice_epidemiology_and_demographics

  The prevalence of neonatal jaundice ranges from 60,000 to 70,000 per 100,000 neonates. The prevalence of the neonatal jaundice decreases as the gestational age of the neonate increases. The prevalence of neonatal jaundice is more in the East Asian, American Indian, and Greek races. […] The prevalence of neonatal jaundice ranges from a low of 60,000 to high of 70,000 per 100,000 neonates in the first week of birth. […] The prevalence of severe hyperbilirubinemia ranges from a low of 8,000 to high of 9,000 per neonates in the first week of birth. […] The prevalence of neonatal jaundice decreases as the gestational age increases. […] Neonatal jaundice affects male more than female neonates. […] The prevalence of neonatal jaundice is more in the East Asian, American Indian, and Greek races. […] Black races are less likely to develop jaundice. Black neonates presenting with jaundice most probably have G6PD deficiency disease.

• #14 Global Prevalence of Severe Neonatal Jaundice among Hospital Admissions: A Systematic Review and Meta-Analysis

  https://www.mdpi.com/2077-0383/12/11/3738

  Evidence regarding the adverse burden of severe neonatal jaundice (SNJ) in hospitalized neonates in resource-constrained settings is sparse. […] The global burden of SNJ in hospitalized neonates remains high, causing substantial, preventable morbidity and mortality especially in LMICs. […] The Global Burden of Disease study ranks SNJ among the top 5–10 causes of neonatal deaths in countries with the highest number of neonatal deaths. […] The prevalence of SNJ among all admitted neonates varied across WHO regions, ranging from 0.73 to 3.34%. […] Among all neonatal admissions, SNJ clinical outcome markers for EBT ranged from 0.74 to 3.81%, with the highest percentage observed in the African and South-East Asian regions. […] The prevalence of SNJ in tertiary/referral hospitals was 7.0% higher than studies that did not report type of healthcare facility.

• #15

  https://journals.lww.com/jocn/fulltext/2020/09010/evaluation_of_neonatal_jaundice_based_on_the.8.aspx

  Recognition of the characteristics of neonatal jaundice with different levels of severity can help the physician with appropriate treatment and prediction of complications. This study aimed to determine the characteristics of neonatal jaundice in different levels of severity. […] Causes of neonatal jaundice included unknown reasons (61.25%), increased production of bilirubin (22%), severe weight loss (7%), infections (5.3%), endocrine disorders (2.5%), and other causes (1.7%). In jaundice level lower than 25 mg/dl, about 15% of neonates were reported with complications; however, at the bilirubin level higher than 35 mg/dl, approximately 40% of newborns had complications. […] Some of the risk factors for neonatal jaundice are prematurity, race, drugs, high altitude, polycythemia, male gender, trisomy 21, cephalohematoma, breastfeeding, weight loss, delayed meconium pass, history of jaundice in family, ABO or RH incompatibility, mode of delivery, and maternal diabetes.

• #16 Factors associated with neonatal jaundice among neonates admitted at referral hospitals in northeast Ethiopia: a facility-based unmatched case-control study | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-024-06352-y

  Neonatal jaundice is a significant contributor to illness and death in newborns, leading to frequent admissions to neonatal intensive care units. […] The study findings revealed that maternal age over 35 years, residing in urban areas, male gender, prematurity, and ABO incompatibility were significant determinants of neonatal jaundice. […] To prevent, diagnose, and treat neonatal jaundice effectively, efforts should primarily focus on managing ABO incompatibility and early detection of prematurity. Additionally, special attention should be given to neonates born through vaginal delivery, those with mothers over 35 years old, and those residing in urban areas, as they are at higher risk of developing newborn jaundice. […] The study also demonstrated that premature neonates were almost four times more susceptible to jaundice compared to full-term neonates. […] Another determinant factor identified was ABO incompatibility. Neonates with ABO incompatibility were more likely to develop neonatal jaundice compared to those without.

• #17 The Epidemiology of Neonatal Hyperbilirubinemia | Obgyn Key

  https://obgynkey.com/the-epidemiology-of-neonatal-hyperbilirubinemia/

  The vast majority of studies in the last 30 years have found a strong association between breastfeeding, elevated TSB levels in the first few days, and an increased risk of subsequent significant hyperbilirubinemia. A pooled analysis of 12 studies of more than 8000 newborns showed that breastfed infants were about three times more likely to develop TSB levels of 12 mg/dL and six times more likely to develop levels of 15 mg/dL than formula-fed infants.

• #18 Epidemiology of Neonatal Jaundice at the University Hospital of the West Indies | West Indian Medical Journal

  https://www.mona.uwi.edu/fms/wimj/article/866

  Epidemiology of Neonatal Jaundice at the University Hospital of the West Indies […] Objective: To describe the epidemiology of neonatal jaundice at the University Hospital of the West Indies (UHWI). […] Methods: A retrospective review of all neonates at the UHWI with clinically significant jaundice between January 1, 2006 and June 30, 2007 was performed. Demographic, clinical and laboratory data were collected. Descriptive analyses were performed. […] Results: The incidence of clinically significant neonatal jaundice at the UHWI was 4.6% for the study period. There were 103 male (61%) and 67 (39%) female infants. The aetiology of jaundice in the infant was attributed to ABO incompatibility in 59 (35%), infection in 30 (18%), prematurity in 19 (11%), G6PD deficiency in 8 (5%), Rhesus incompatibility in 6 (3.5%) and no cause was identified in 16 (9%) infants. There was a low incidence (26%) of screening for G6PD deficiency although it was the most common aetiology for infants presenting from home. Nine (5%) neonates required exchange blood transfusion. Infants admitted from home had a significantly higher mean total bilirubin value at presentation, a significantly higher mean peak bilirubin level and presented significantly later than those who were admitted from the postnatal ward (p 0.001). One patient was discharged with a diagnosis of bilirubin encephalopathy but defaulted from follow-up. Two neonates died but from causes unrelated to neonatal jaundice. Sixty-two patients (37%) were followed-up post discharge; 50% had hearing tests done, all tests were normal. Sixty-one (98%) infants had normal development at the time of the study; one patient had impaired motor development but this infant also had a myelomeningocoele. […] Conclusion: To further reduce morbidity associated with neonatal jaundice at the UHWI, there should be increased screening for G6PD deficiency; current systems in place for follow-up and monitoring of infants discharged from hospital prior to 72 hours must also be expanded and strengthened.

• #19 Epidemiology and Risk Factors for Neonatal Jaundice in Infants Admitted to NICU of Imam Sajjad Hospital Yasooj – Avicenna Journal of Clinical Medicine

  http://sjh.umsha.ac.ir/article-1-563-en.html

  Jaundice is a common problem in infants in the first days after birth. The objective of this study was to determine the prevalence and risk factors affecting neonatal jaundice. […] In this study on 3461 newborns, 579 infants (72.16%) had jaundice. The prevalence of hepatitis was 16.72%, largely due to ABO incompatibility and G6PD deficiency. It is recommended to determine the infants blood group (especially infants of mothers with blood group O) and measure neonatal bilirubin to prevent injury in infants who are at risk.

• #20 The Epidemiology of Neonatal Hyperbilirubinemia | Obgyn Key

  https://obgynkey.com/the-epidemiology-of-neonatal-hyperbilirubinemia/

  Neonatal jaundice runs in families. Khoury et al. studied a population of 3301 newborns born to male US army veterans between 1966 and 1986. If one or more previous siblings had a TSB 12 mg/dL, the subsequent sibling was three times more likely than controls (10.3% vs. 3.6%) to develop a TSB 12 mg/dL, and if a prior sibling had a TSB level 15 mg/dL, the risk in the subsequent sibling was increased 12.5-fold (10.5% vs. 0.9%). These relationships applied whether or not the siblings were breastfed or formula fed. The familial nature of hyperbilirubinemia has also been documented in Chinese and Danish infants. […] The genetics of neonatal jaundice and the inborn errors of hepatic bilirubin uridine diphosphate glucuronosyltransferase (UGT) expression are discussed in detail in Chapter 1. Gilberts syndrome is not generally classified as a pathologic entity in a newborn, but newborn infants who are heterozygous or homozygous for Gilberts syndrome (i.e., they have the variant UGT genotype) have significantly elevated bilirubin levels in the first 24 days, compared with homozygous normal infants. In addition to a decreased ability to conjugate bilirubin, infants with Gilberts syndrome also appear to have an increase in red cell turnover and therefore bilirubin production. By itself, the presence of Gilberts syndrome has a relatively modest effect on TSB levels in the neonate but, when combined with other icterogenic factors, Gilberts syndrome plays a ubiquitous role in the pathogenesis of neonatal hyperbilirubinemia.

• #21 Detection of jaundice in newborn babies

  https://www.hssib.org.uk/patient-safety-investigations/detection-of-jaundice-in-newborn-babies/

  This report explored the detection and diagnosis of jaundice in newborn babies, in particular babies born prematurely (before 37 weeks of pregnancy). […] Jaundice is a condition caused by too much bilirubin in a persons blood. […] If left undiagnosed and untreated, high bilirubin levels in newborn babies can lead to significant harm. […] Newborn babies have a higher number of red blood cells in their blood which increases their risk of jaundice. […] High bilirubin levels can cause significant harm including brain damage. It is therefore important that jaundice is diagnosed and treated in a timely way. […] It is nationally acknowledged that the recognition and assessment of jaundice can be difficult, particularly in babies with black or brown skin, increasing the risk of delayed diagnosis.

• #22 Detection of jaundice in newborn babies

  https://www.hssib.org.uk/patient-safety-investigations/detection-of-jaundice-in-newborn-babies/

  The assessment of visual signs of jaundice in newborn babies is subjective and more challenging with babies who have black or brown skin. […] National guidance does not contain information on how to address the challenges of detecting jaundice in newborn babies with black or brown skin. […] HSIB recommends that the National Institute for Health and Care Excellence reviews the available evidence and updates its guidance if appropriate, regarding: the reliability of visual signs to detect jaundice in newborn babies, particularly in babies with black and brown skin. […] HSIB recommends that the Royal College of Pathologists works with stakeholders to understand current practice and make any appropriate recommendations to promote the adoption of an icteric threshold at which a bilirubin test may be cascaded or reported.

• #23 Reliability of visual assessment of neonatal jaundice among neonates of black descent: a cross-sectional study from Tanzania | BMC Pediatrics | Full Text

  https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-021-02859-x

  The prevalence of NJ was 49.8% by Kramers method and 63.5% by TSB. […] The Sensitivity, Specificity, PPV, and NPV of Kramers method were 70.5, 86.1, 89.8, and 62.6%, respectively. […] The diagnostic accuracy of Kramers method was 76.1%. […] Kramers method has a good positive predictive value. However, due to low sensitivity and NPV one cannot say that overall predictive ability is good. […] Kramers method is the backbone in diagnosis of NJ in most of the low-level health facilities in low and middle income countries like Tanzania. […] Kramers method had a Sensitivity-70.5%, Specificity-86.1%, PPV-89.8%, and NPV-62.6% in detecting NJ. […] Kramers method was found to have good ability of predicting presence of NJ (89.8%). […] Kramers method may be used as a predictor (PPV =89.8%) of NJ rather than confirmatory test for the presence of NJ. […] The study aimed at determining the reliability of Kramers method for assessment of NJ among neonates of black descent. […] Further studies are needed to investigate the utility of other non-invasive techniques in detecting NJ among neonates of black descent.

• #24 Assessment, management, and incidence of neonatal jaundice in healthy neonates cared for in primary care: a prospective cohort study | Scientific Reports

  https://www.nature.com/articles/s41598-022-17933-2

  Jaundice caused by hyperbilirubinaemia is a common phenomenon during the neonatal period. […] Population-based studies evaluating assessment, management, and incidence of jaundice and need for phototherapy among otherwise healthy neonates are scarce. […] Jaundice is common in otherwise healthy neonates cared for in primary care. TSB quantification was not always performed in very jaundiced neonates, and not all neonates received phototherapy when indicated. […] Although neonatal jaundice is commonly observed, population-based data on the assessment, management, and incidence of visual jaundice and need for phototherapy among healthy neonates, especially if cared for in primary care, are scarce. […] The STARSHIP Trial is conducted in seven PCBCs throughout the Netherlands where MCAs provide postpartum care, supervised by community midwives.

• #25 Assessment, management, and incidence of neonatal jaundice in healthy neonates cared for in primary care: a prospective cohort study | Scientific Reports

  https://www.nature.com/articles/s41598-022-17933-2

  The control phase is followed by a second phase in which one intervention is implemented (i.e., transcutaneous bilirubin screening or phototherapy in the PCBC rather than in-hospital) and eventually by a final phase in which both interventions are implemented (i.e., transcutaneous bilirubin screening and phototherapy in the PCBC). […] In our prospective cohort study evaluating the assessment, management, and incidence of neonatal hyperbilirubinaemia and the need for phototherapy among neonates cared for in primary care, we found that approximately 70% of neonates became jaundiced at any point during the first days of life and that 3.6% received treatment for hyperbilirubinaemia. […] However, not all neonates who had a TSB level that exceeded the phototherapy threshold received phototherapy.

• #26 Assessment, management, and incidence of neonatal jaundice in healthy neonates cared for in primary care: a prospective cohort study | Scientific Reports

  https://www.nature.com/articles/s41598-022-17933-2

  Our evaluation of standard practice in this cohort highlights significant gaps in guideline application. […] The incidence of visible jaundice in our study is comparable to other studies in (near) term neonates in which 60-90% became jaundiced. […] Our current evaluation of care-as-usual indicates that TcB or TSB is often not quantified even in neonates who were considered quite yellow or very yellow. […] More objective approaches to universal hyperbilirubinaemia screening, for example using a transcutaneous bilirubinometer, should be considered to improve early recognition of potentially severe hyperbilirubinaemia.

• #27 Jaundice in the newborn infant

  https://acutecaretesting.org/en/articles/jaundice-in-the-newborn-infant

  About half of all newborn infants born at term develop jaundice during their first days of life, and the lower the gestational age the more frequent the jaundice is. […] In recent years, the industrialized world has seen an increasing number of term or near-term infants with classic kernicterus. […] At present the initial screening for jaundice is done visually. […] The 2004 guidelines from AAP (American Academy of Pediatrics) advise a systematic assessment before discharge for the risk of hyperbilirubinemia. […] A screening of term and near-term infants by measurement of the transcutaneous bilirubin concentration has been proposed. […] Due to the increased number of infants with classic kernicterus and the difficulty of assessing the intensity of jaundice in infants with dark skin, a screening of term and near-term infants has been proposed by measurement of the transcutaneous bilirubin concentration. […] The 2004 guidelines from AAP (American Academy of Pediatrics) advise a systematic assessment before discharge for the risk of hyperbilirubinemia.

• #28 Guidelines for detection and management of hyperbilirubinemia in term and late preterm newborns (≥35 weeks gestational age) | Canadian Paediatric Society

  https://cps.ca/documents/position/hyperbilirubinemia-newborns

  Determining neurotoxicity risk in a newborn requires clinical judgement. […] The new phototherapy thresholds based on gestational age (GA) and the presence of bilirubin neurotoxicity risk factors are described below. […] The TSB should be used to guide discharge planning: first to determine whether discharge should be delayed pending further TSB measurement(s) or phototherapy treatment, then if an infant is eligible for discharge, to time follow-up. […] All newborns should have a physical assessment within the first 24 hours post-birth by a health care provider. […] In addition to universal screening with a timed TSB or TcB, clinical surveillance to identify neonates at risk for significant hyperbilirubinemia should be part of all newborn assessments. […] A process must be in place to ensure timely post-discharge follow-up of newborns at intervals based on the TSB, such that jaundiced infants can be assessed and treated promptly.

• #29 Newborn jaundice: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001559.htm

  Newborn jaundice occurs when a baby has a high level of bilirubin in the blood. […] Most newborns have some jaundice. This is called physiological jaundice. It is usually noticeable when the baby is 2 to 4 days old. Most of the time, it does not cause problems and goes away within 2 weeks. […] Babies who are born too early (premature) are more likely to develop jaundice than full-term babies. […] Your baby’s health care providers will watch for signs of jaundice at the hospital. After the newborn goes home, family members will usually spot the jaundice. […] All babies should be seen by a provider in the first 5 days of life to check for jaundice. […] Jaundice is generally not dangerous in babies who were born full term and who do not have other medical problems. […] In newborns, some degree of jaundice is normal and probably not preventable. The risk for serious jaundice can often be reduced by feeding babies at least 8 to 12 times a day for the first several days and by carefully identifying infants at highest risk. […] Careful monitoring of all babies during the first 5 days of life can prevent most complications of jaundice.

• #30 Surveillance decision | Evidence | Jaundice in newborn babies under 28 days | Guidance | NICE

  https://www.nice.org.uk/guidance/cg98/resources/2023-exceptional-surveillance-of-jaundice-in-newborns-under-28-days-nice-guideline-cg98-13197079837/chapter/Surveillance-decision?tab=evidence

  We will change: […] The HSIB report highlighted the issue of delay in the diagnosis of jaundice in newborns with black or brown skin-colour, in whom visual signs were not noted. […] The report recommends that guidelines are reviewed with respect to neonatal assessment by skin colour specifically for jaundice to draw attention to differences in assessment techniques for Black, Asian and ethnic minority neonates. […] The evidence identified in this review was inconclusive about the impact of skin tone on diagnostic accuracy of various approaches to detect jaundice/measure bilirubin, largely due to studies not having comparator groups. […] In conclusion there is currently insufficient new evidence to update the consensus-based bilirubin threshold table for a specific subgroup of babies with darker skin tones.

• #31 WHO EMRO | Root causes for late presentation of severe neonatal hyperbilirubinaemia in Egypt | Volume 18, issue 8 | EMHJ volume 18, 2012

  https://www.emro.who.int/emhj-volume-18-2012/issue-8/article-13.html

  The aim of this study was to prospectively evaluate the social, cultural, educational and systems-related factors contributing to the late presentation of infants with severe neonatal hyperbilirubinaemia to a public (free-of-charge) hospital in Egypt. […] The study identified many key factors leading to the late presentation of cases with severe neonatal hyperbilirubinaemia, which can precipitate the occurrence of bilirubin encephalopathy and eventually kernicterus, thus providing a framework to construct solutions. […] There is an urgent need to develop comprehensive educational and training programmes for health care workers throughout the country regarding the neurotoxic potential of bilirubin, the exposure-time factor and how to avoid it. […] In Egypt, increasing the availability of inexpensive point-of-care diagnostic instruments and phototherapy units in health care facilities throughout the country and training personnel to use them are urgently needed. […] Delayed presentation of severe neonatal hyperbilirubinaemia is one of the main root causes that can result in kernicterus.

• #32 GitHub – mj129/Surveillance-of-neonatal-jaundice: Surveillance of neonatal jaundice using sternal skin images via deep learning

  https://github.com/mj129/Surveillance-of-neonatal-jaundice

  Surveillance of neonatal jaundice using sternal skin images via deep learning. […] This repository is the code for paper 'Surveillance of neonatal jaundice using sternal skin images via deep learning’. The paper is currently under review and has not been formally accepted. […] This code uses convolutional neural network to estimate neonatal jaundice of sternal skin images. […] Surveillance of neonatal jaundice using sternal skin images via deep learning.

• #33 Neonatal jaundice – O&G Magazine

  https://www.ogmagazine.org.au/25/4-25/neonatal-jaundice/

  For low-risk newborns with bilirubin levels close to treatment thresholds, several centres can offer home phototherapy. […] Given its cost-effectiveness, home phototherapy will likely become a main form of treatment for low-risk babies with physiological jaundice requiring treatment. […] Newborn jaundice is a condition encountered in newborns, commonly due to physiological transitions and, rarely, pathological processes. […] Clinical examination cannot determine the level of jaundice in a baby, and babies with jaundice in the first 24 hours or persisting after two weeks require urgent/close reviews, respectively. […] Phototherapy and regular feeding continue to remain the most effective way to assist babies in offloading bilirubin. […] Home phototherapy with POC diagnostics is a highly cost-effective and rewarding technique to foster maternal-infant bonding and will likely become a key method of care for low-risk neonates needing ongoing jaundice management.

• #34 Unconjugated hyperbilirubinemia in neonates: Risk factors, clinical manifestations, and neurologic complications – UpToDate

  https://www.uptodate.com/contents/unconjugated-hyperbilirubinemia-in-neonates-risk-factors-clinical-manifestations-and-neurologic-complications

  Unconjugated hyperbilirubinemia in neonates: Risk factors, clinical manifestations, and neurologic complications […] The epidemiology, risk factors, clinical manifestations, and neurologic complications of neonatal unconjugated hyperbilirubinemia are reviewed here. […] Nearly all newborn infants develop elevated bilirubin levels (ie, total serum bilirubin [TSB] >1 mg/dL [17 micromol/L], which is the upper limit of normal for adults). […] Neonates with severe hyperbilirubinemia (defined as TSB >25 mg/dL [428 micromol/L] in newborns ≥35 weeks gestational age [GA]) are at risk for developing bilirubin-induced neurologic disorders (BIND).

• #35

  https://journals.lww.com/jocn/fulltext/2020/09010/evaluation_of_neonatal_jaundice_based_on_the.8.aspx

  Kernicterus or bilirubin encephalopathy, as a preventable neurological syndrome with undesirable side effects, is caused by unconjugated bilirubin deposition in the cortical nuclei and brain stem. […] Discharge avoidance of neonates at risk of jaundice, appropriate follow-up after discharge, informing parents of the importance and follow-up of neonatal jaundice, phototherapy, and in resistant cases, rapid blood exchange in neonates can reduce the complications of jaundice. […] Appropriate strategy in the diagnosis, treatment, and follow-up of jaundice has always been one of the major challenges in neonatal medicine. Prevention of jaundice, early diagnosis, as well as proper treatment and prevention of related complications, can reduce the problems of neonatal jaundice. […] Considering the high prevalence of jaundice in Asian countries, such as Iran, associated with serious complications, and since the early referral of neonates with jaundice to hospitals and proper management increase the health of neonates and reduce the associated problems, this study aimed to identify the characteristics of neonates with jaundice in different levels of severity.

• #36

  https://journals.lww.com/jocn/fulltext/2020/09010/evaluation_of_neonatal_jaundice_based_on_the.8.aspx

  The complications of neonatal hyperbilirubinemia included acute kernicterus, abnormal auditory brainstem response (ABR), developmental delay at the age of 3 years old, and abnormal eye status. […] The most common known causes of jaundice were increased bilirubin production (22%), severe weight loss (7%), infections (5.3%), and endocrine causes (1.7%). Hemolytic causes played a greater role in increasing the severity of jaundice so that 64% of neonates with bilirubin levels 35 mg/dl had hemolytic causes.

• #37 Global Prevalence of Severe Neonatal Jaundice among Hospital Admissions: A Systematic Review and Meta-Analysis

  https://www.mdpi.com/2077-0383/12/11/3738

  Our data demonstrate that adverse clinical outcomes of SNJ remains a significant public health concern in LMICs. […] SNJ contributes substantially to neonatal mortality worldwide, with the highest burden in the African (1.49%) and South-East Asian (0.82%) WHO regions. […] The current review highlights that NNJ is noted in 21.99% of all neonatal admissions across WHO regions in the studies included in our review, consistent with prior studies. […] Striking differences persist between WHO regions for individual SNJ markers again with wide ranges for both ABE and percentages of neonates requiring EBTs.

• #38 (PDF) Journal of Public Health and Epidemiology Prevalence of neonatal jaundice in Eku Baptist Community Hospital in Delta State Nigeria

  https://www.academia.edu/32662706/Journal_of_Public_Health_and_Epidemiology_Prevalence_of_neonatal_jaundice_in_Eku_Baptist_Community_Hospital_in_Delta_State_Nigeria?from_sitemaps=true&version=2

  Neonatal jaundice is a very common condition worldwide, occurring in up to 60% of term and 80% of preterm new born in the first week of life. […] In Nigeria, it accounts for between 23% and 60% of admission into the Special Care Baby Unit (SCBU), and various factors are responsible for its occurrence. […] Available evidence suggests that low-and middle-income countries (LMICs) bear the greatest burden of severe neonatal jaundice characterized by very high rates of morbidity, mortality and long-term sequel compared to high-income countries (HICs). […] Neonatal jaundice is common in our setting with possible dire consequences. Health education of the public on its associated modifiable risk factors is desirable. […] The incidence, aetiological and contributory factors to neonatal jaundice differs in ethnicity and geographical distribution.

• #39 Journal of Public Health and Epidemiology – prevalence of neonatal jaundice in eku baptist community hospital in delta state nigeria

  https://books.academicjournals.org/journal/JPHE/article-full-text/94BCA4D57964

  Since all healthy newborns are at potential risk if their jaundice is unmonitored or managed inappropriately, there is need to address the social demand for patient safety and to respond to calls for a public health policy to better manage the disease. Documenting the prevalence, identifying risk factors for severe hyperbilirubinaemia prior to discharge, lactation support to ensure optimal feeding, and parents education for hyperbilirubinaemia and keeping follow-up are necessary (Newman et al., 2006). […] The prevalence of neonatal jaundice at Eku Hospital was low, but the occurrence of neonatal jaundice and few deaths due to sepsis cannot be overlooked. Health care providers working with neonates should play a key role in identifying the associated risk factors and assessing neonates for pathological jaundice. Parental counseling, education for early detection, regular antenatal care, and longer hospital stay are required in order to prevent this condition.

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