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: 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.

• #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 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.

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

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

  About 5% of healthy term and near-term infants receive PT for NJ/HB. […] Worldwide 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.

• #7 Neonatal Jaundice – StatPearls – NCBI Bookshelf

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

  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.

• #8 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.

• #9 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.

• #10 The Epidemiology of Neonatal Hyperbilirubinemia | Obgyn Key

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

  In order to develop an approach to the diagnosis and management of the jaundiced newborn, it is necessary to understand the nonpathologic factors that can affect bilirubin levels in the normal newborn infant as well as the natural history of neonatal bilirubinemia. Many factors have been identified in large epidemiologic studies as having some effect on neonatal bilirubin levels, but their clinical relevance is often questionable. Those that have been shown in recent studies to have an important influence on total serum bilirubin (TSB) levels are listed in Table 6-1. […] Mean maximum TSB concentrations in East Asian, Native American, and some Hispanic infants (primarily those of Mexican descent) are significantly higher than those in white infants. In a study of Hispanic infants, 31% had peak TSB levels 15 mg/dL compared with 310% of infants in other US populations. The mechanisms responsible for these differences are unknown, although there is some evidence that in the Native American population, increased bilirubin production plays a role. Black infants in the United States and Great Britain have lower TSB levels than white infants.

• #11 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.

• #12 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.

• #13 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.

• #14 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.

• #15 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.

• #16 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.

• #17 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.

• #18 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.

• #19 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.

• #20 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.

• #21 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.

• #22 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.

• #23 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.

• #24 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 the cohort of neonates with jaundice, the prevalence of SNJ ranged from 8.31 to 31.49%, with the highest percentage observed in the African region. […] The prevalence of EBT among all neonates was the highest in the African region (3.81%, 95% CI: 2.145.92%), followed by the South-East Asian region (3.50%, 95% CI: 1.695.90%). […] The highest proportion of jaundice-related deaths among all neonates was 1.49% (95% CI: 0.852.28%) in the African region.

• #25 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 the cohort of neonates with jaundice, the prevalence of SNJ ranged from 8.31 to 31.49%, with the highest percentage observed in the African region. […] The prevalence of EBT among all neonates was the highest in the African region (3.81%, 95% CI: 2.145.92%), followed by the South-East Asian region (3.50%, 95% CI: 1.695.90%). […] The highest proportion of jaundice-related deaths among all neonates was 1.49% (95% CI: 0.852.28%) in the African region.

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

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

  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.

• #27 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.

• #28 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. […] Some of the current challenges in newborn jaundice surveillance are highlighted. […] The current UK incidence of bilirubin encephalopathy is 0.9/100,000 with a higher reported incidence in some countries.

• #29 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.

• #30 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). […] High bilirubin levels can cause significant harm including brain damage. It is therefore important that jaundice is diagnosed and treated in a timely way. This relies on visual signs of jaundice being present and observed by clinical staff. 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. […] 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.

• #31 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 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. […] Kramers method had moderate agreement with TSB test (=52.4, P0.01). […] Further studies are needed to investigate the utility of other non-invasive techniques in detecting NJ among neonates of black descent.

• #32 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 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. […] Kramers method had moderate agreement with TSB test (=52.4, P0.01). […] Further studies are needed to investigate the utility of other non-invasive techniques in detecting NJ among neonates of black descent.

• #33 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. […] Non-compliance to neonatal jaundice guidelines can have potentially severe consequences. […] 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.

• #34 Neonatal Jaundice | ACG

  https://gi.org/topics/neonatal-jaundice/

  If the doctor is concerned about the severity of the jaundice, a blood test called a serum total bilirubin level is performed using a very small amount of blood. Other tests such as a transcutaneous (through the skin) test may be used to determine the bilirubin level in certain hospitals. This test is less accurate and needs to be confirmed with blood testing. […] The treatment varies based on the cause of the jaundice and the bilirubin level. For the purpose of this information we will discuss only the treatment for the elevation of the unconjugated or indirect bilirubin pigment. We will not discuss the jaundice associated with liver disease or the rare diseases causing an elevation of the pigment called conjugated or direct bilirubin.

• #35 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 American Academy of Pediatrics (AAP) published revised guidance in 2022 with new recommendations for the prevention, assessment, and management of neonatal hyperbilirubinemia. Their recommendations were based on current best evidence and, when that was lacking, on consensus and expert opinion. Several elements from the AAP guideline have been incorporated into the new CPS statement, specifically: A universal screening strategy to identify neonates at risk for developing severe hyperbilirubinemia, an algorithm to assess and monitor neonates for hyperbilirubinemia, treatment, investigation, and monitoring protocols for neonates with hyperbilirubinemia, and follow-up for neonates treated for hyperbilirubinemia following hospital discharge.

• #36 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). […] High bilirubin levels can cause significant harm including brain damage. It is therefore important that jaundice is diagnosed and treated in a timely way. This relies on visual signs of jaundice being present and observed by clinical staff. 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. […] 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.

• #37 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. […] The 2004 guidelines from AAP (American Academy of Pediatrics) advise a systematic assessment before discharge for the risk of hyperbilirubinemia. […] 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 reasons for this may be: The infants are discharged earlier from the maternity ward, so that the jaundice culminates after discharge from the ward. […] Screening of infants of non-Caucasian origin for the risk of developing a high plasma bilirubin concentration might be reasonable.

• #38

  https://journals.lww.com/njcp/fulltext/2016/19010/the_burden_and_management_of_neonatal_jaundice_in.1.aspx

  Late presentation in hospitals was therefore a major contributor to the high incidence of avoidable exchange transfusions and adverse outcomes among infants with SNH in Nigeria. […] Practice guidelines for the prevention, diagnosis and management of infants with SNH do not exist in Nigeria. […] Effective first-line treatment with conventional blue-light phototherapy requires light emission spectrum within the bilirubin absorption spectrum of 400-520 nm (peak 450 ± 20 nm); irradiance level 30 W/cm2/nm, exposed to ~80% of an infant’s body surface area, and optimized duration of exposure. […] However, in one survey, the vast majority (94%) of 63 phototherapy devices tested in twelve referral level hospitals delivered irradiances of 10 W/cm2/nm and none were 30 W/cm2/nm. […] The exclusion of SNH in the global agenda for newborn care within the MDG framework in the last 15 years has contributed in no small measure to the lack of globally-backed national programs for this condition.

• #39

  https://journals.lww.com/njcp/fulltext/2016/19010/the_burden_and_management_of_neonatal_jaundice_in.1.aspx

  Late presentation in hospitals was therefore a major contributor to the high incidence of avoidable exchange transfusions and adverse outcomes among infants with SNH in Nigeria. […] Practice guidelines for the prevention, diagnosis and management of infants with SNH do not exist in Nigeria. […] Effective first-line treatment with conventional blue-light phototherapy requires light emission spectrum within the bilirubin absorption spectrum of 400-520 nm (peak 450 ± 20 nm); irradiance level 30 W/cm2/nm, exposed to ~80% of an infant’s body surface area, and optimized duration of exposure. […] However, in one survey, the vast majority (94%) of 63 phototherapy devices tested in twelve referral level hospitals delivered irradiances of 10 W/cm2/nm and none were 30 W/cm2/nm. […] The exclusion of SNH in the global agenda for newborn care within the MDG framework in the last 15 years has contributed in no small measure to the lack of globally-backed national programs for this condition.

• #40

  https://link.springer.com/article/10.1007/s12519-020-00347-3

  The outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV) has become a most challenging health emergency. […] Owing to rigorous quarantine and control measures taken in China, routine neonatal health surveillance and follow-up have become challenging. […] Without follow-up surveillance, some rapid and progressive newborn diseases, such as bilirubin encephalopathy, may be ignored. […] The characteristics of onset age of kernicterus suggest that monitoring of bilirubin level at home provides a useful way to alert hospital visits and to prevent the development of extremely hyperbilirubinemia. […] The aim is to make our management strategies of neonatal jaundice tailored to the infection prevention and control during the COVID-19 epidemic. […] Neonatal out-patient visits are of utmost important to those with hyperbilirubinemia.

• #41

  https://link.springer.com/article/10.1007/s12519-020-00347-3

  For unrecognized and accelerated severe early neonatal hyperbilirubinemia, appropriate interventions are utmost important to reduce the risks of neurological dysfunction, kernicterus, or even death. […] An important finding of the study is that these patients presented with symptoms around ages of 56 days, and were mostly at home. […] The characteristics of onset age of kernicterus suggest that monitoring of bilirubin level at home is a useful way to alert hospital visit and to prevent the development of extreme hyperbilirubinemia. […] Therefore, we developed an online follow-up program for convenient monitoring of bilirubin level of newborns that is based on our practical experiences. […] The management plan is developed based on the risk zones as follows: […] TCB level95th percentile (high-risk zone): the risk of subsequent significant hyperbilirubinemia is very high; TSB should be checked.

• #42 GP250 NEONATAL JAUNDICE SURVEILLANCE- ARE WE WINNING? | Archives of Disease in Childhood

  https://adc.bmj.com/content/104/Suppl_3/A134.1

  Objectives To determine the incidence of babies presenting with Serum bilirubin (SBR)400micromol/litre in last five years (20132017) […] Conclusion Incidence of babies presenting with SBR400micromol/l has significantly reduced in last five years. This could be secondary to introduction of TcB in community and improvement in jaundice surveillance system. However there is still margin for improvement as new cases are still presenting either due to inappropriate monitoring in community or discrepancy in co-relation of levels between TcB and SBR.

• #43 Neonatal Jaundice Clinical Presentation: History, Physical Examination

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

  Hansen TW. Narrative review of the epidemiology of neonatal jaundice. Pediatr Med. 2021 May 28. 4:4-18. [Full Text]. […] Olusanya BO, Kaplan M, Hansen TWR. Neonatal hyperbilirubinaemia: a global perspective. Lancet Child Adolesc Health. 2018 Aug. 2 (8):610-20. [QxMD MEDLINE Link]. […] Linn S, Schoenbaum SC, Monson RR, Rosner B, Stubblefield PG, Ryan KJ. Epidemiology of neonatal hyperbilirubinemia. Pediatrics. 1985 Apr. 75 (4):770-4. [QxMD MEDLINE Link]. […] Kuzniewicz MW, Wickremasinghe AC, Wu YW, et al. Incidence, etiology, and outcomes of hazardous hyperbilirubinemia in newborns. Pediatrics. 2014 Sep. 134 (3):504-9. [QxMD MEDLINE Link]. […] Mah MP, Clark SL, Akhigbe E, et al. Reduction of severe hyperbilirubinemia after institution of predischarge bilirubin screening. Pediatrics. 2010 May. 125 (5):e1143-8. [QxMD MEDLINE Link]. […] Bhutani VK, Johnson LH, Jeffrey Maisels M, et al. Kernicterus: epidemiological strategies for its prevention through systems-based approaches. J Perinatol. 2004 Oct. 24 (10):650-62. [QxMD MEDLINE Link].

• #44 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. […] Some of the current challenges in newborn jaundice surveillance are highlighted. […] The current UK incidence of bilirubin encephalopathy is 0.9/100,000 with a higher reported incidence in some countries.

• #45 Risk of Brain Disorder Rare in Healthy Newborns with Jaundice | UC San Francisco

  https://www.ucsf.edu/news/2015/01/122586/risk-brain-disorder-rare-healthy-newborns-jaundice

  A study tracking more than 100,000 infants has shown that newborns with jaundice that are otherwise healthy are highly unlikely to develop a severe and potentially deadly form of cerebral palsy. […] The study, which evaluated the health records of two groups of babies selected from 525,409 births, was led by Yvonne W. Wu, MD, MPH, professor of clinical neurology and pediatrics at UCSF Benioff Childrens Hospital San Francisco. […] Our study was the first to evaluate how well the exchange transfusion guidelines predicted risk of cerebral palsy and kernicterus in babies with jaundice, said principal investigator Thomas B. Newman, MD, MPH, of the departments of epidemiology and pediatrics at UCSF Benioff Childrens Hospital San Francisco. […] Based on our study, the current guidelines for when to perform exchange transfusions have been quite successful in preventing kernicterus.

• #46 Risk of Brain Disorder Rare in Healthy Newborns with Jaundice | UC San Francisco

  https://www.ucsf.edu/news/2015/01/122586/risk-brain-disorder-rare-healthy-newborns-jaundice

  A study tracking more than 100,000 infants has shown that newborns with jaundice that are otherwise healthy are highly unlikely to develop a severe and potentially deadly form of cerebral palsy. […] The study, which evaluated the health records of two groups of babies selected from 525,409 births, was led by Yvonne W. Wu, MD, MPH, professor of clinical neurology and pediatrics at UCSF Benioff Childrens Hospital San Francisco. […] Our study was the first to evaluate how well the exchange transfusion guidelines predicted risk of cerebral palsy and kernicterus in babies with jaundice, said principal investigator Thomas B. Newman, MD, MPH, of the departments of epidemiology and pediatrics at UCSF Benioff Childrens Hospital San Francisco. […] Based on our study, the current guidelines for when to perform exchange transfusions have been quite successful in preventing kernicterus.

• #47

  https://journals.lww.com/njcp/fulltext/2016/19010/the_burden_and_management_of_neonatal_jaundice_in.1.aspx

  Late presentation in hospitals was therefore a major contributor to the high incidence of avoidable exchange transfusions and adverse outcomes among infants with SNH in Nigeria. […] Practice guidelines for the prevention, diagnosis and management of infants with SNH do not exist in Nigeria. […] Effective first-line treatment with conventional blue-light phototherapy requires light emission spectrum within the bilirubin absorption spectrum of 400-520 nm (peak 450 ± 20 nm); irradiance level 30 W/cm2/nm, exposed to ~80% of an infant’s body surface area, and optimized duration of exposure. […] However, in one survey, the vast majority (94%) of 63 phototherapy devices tested in twelve referral level hospitals delivered irradiances of 10 W/cm2/nm and none were 30 W/cm2/nm. […] The exclusion of SNH in the global agenda for newborn care within the MDG framework in the last 15 years has contributed in no small measure to the lack of globally-backed national programs for this condition.

• #48 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. Benign jaundice is often self-resolving with time and increased feeds, whereas jaundice in at-risk babies or with a pathologic origin requires investigation and close observation.

• #49

  https://link.springer.com/article/10.1007/s12519-020-00347-3

  The WHO vaccination guidelines did not regard neonatal jaundice as the contraindication of vaccination, and there was no clinical evidence that high bilirubin level is an effect of vaccination. […] During the online follow-up, if any of the following criteria are met, the newborn infant should be taken to the hospital as soon as possible: […] For infants with significant hyperbilirubinemia, we recommend intervention after admission, as the out-patient daytime phototherapy will increase the risk of SARS-CoV-2 infection.

• #50 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 American Academy of Pediatrics (AAP) published revised guidance in 2022 with new recommendations for the prevention, assessment, and management of neonatal hyperbilirubinemia. Their recommendations were based on current best evidence and, when that was lacking, on consensus and expert opinion. Several elements from the AAP guideline have been incorporated into the new CPS statement, specifically: A universal screening strategy to identify neonates at risk for developing severe hyperbilirubinemia, an algorithm to assess and monitor neonates for hyperbilirubinemia, treatment, investigation, and monitoring protocols for neonates with hyperbilirubinemia, and follow-up for neonates treated for hyperbilirubinemia following hospital discharge.

• #51 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. […] Non-compliance to neonatal jaundice guidelines can have potentially severe consequences. […] 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.

• #52 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). […] High bilirubin levels can cause significant harm including brain damage. It is therefore important that jaundice is diagnosed and treated in a timely way. This relies on visual signs of jaundice being present and observed by clinical staff. 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. […] 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.

• #53 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. […] The 2004 guidelines from AAP (American Academy of Pediatrics) advise a systematic assessment before discharge for the risk of hyperbilirubinemia. […] 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 reasons for this may be: The infants are discharged earlier from the maternity ward, so that the jaundice culminates after discharge from the ward. […] Screening of infants of non-Caucasian origin for the risk of developing a high plasma bilirubin concentration might be reasonable.

• #54 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 lack of awareness among health care workers in maternity settings about bilirubin biology and its potential for neurotoxicity and the absence of set protocols for predischarge examination and follow-up instructions regarding jaundice in low-income health care facilities in our country are similar to problems prompting revision of the AAP guidelines in the United States in 2004. […] This 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.

• #55 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 lack of awareness among health care workers in maternity settings about bilirubin biology and its potential for neurotoxicity and the absence of set protocols for predischarge examination and follow-up instructions regarding jaundice in low-income health care facilities in our country are similar to problems prompting revision of the AAP guidelines in the United States in 2004. […] This 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.

• #56

  https://www.ijpediatrics.com/index.php/ijcp/article/view/2044

  Neonatal jaundice is the most common cause of readmission after discharge from birth hospitalization. […] Breast feeding failure jaundice (BFFJ) contributed to one third of cases of neonatal pathological jaundice requiring re-admission and is the second most common cause after exaggerated physiological jaundice. The high incidence of BFFJ in the study warrants focused efforts for a structured program of breast-feeding education, training and surveillance.

• #57

  https://journals.lww.com/njcp/fulltext/2016/19010/the_burden_and_management_of_neonatal_jaundice_in.1.aspx

  Neonatal jaundice is a leading cause of hospitalization in the first week of life worldwide. […] We set out to describe the epidemiology of neonatal hyperbilirubinemia as well as the practices and challenges in the care of infants with significant neonatal hyperbilirubinemia (SNH) in Nigeria, as basis for policy intervention and research priorities. […] SNH accounted for about one in five neonatal admissions and has been associated consistently with substantial case fatality and neuro-developmental sequelae such as cerebral palsy and auditory impairments, especially among out-born babies. […] Late presentation at appropriate health facilities was common and resulted in high rates of acute bilirubin encephalopathy (ABE), kernicterus and avoidable exchange transfusions. […] Uniform practice guidelines, including developmental assessment and surveillance of infants with SNH, were rare at all levels of healthcare delivery.

• #58

  https://iraqmedj.org/index.php/imj/article/view/1241

  This study aimed to assess the prevalence of neonatal jaundice and explore associated risk factors in Tikrit City, Iraq. […] The prevalence of neonatal jaundice is (9.2%). […] This study highlights a prevalence of 9.2% for neonatal jaundice in Tikrit City and identifies important risk factors such as blood group incompatibility and preterm birth. Early detection and appropriate management of neonatal jaundice are crucial to prevent potential complications and ensure optimal neonatal care.

• #59 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

  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.

• #60 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

  Objective: To describe the epidemiology of neonatal jaundice at the University Hospital of the West Indies (UHWI). […] The incidence of clinically significant neonatal jaundice at the UHWI was 4.6% for the study period. […] 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.

• #61 Epidemiology: Open Access – Detection of Neonatal Jaundice among the Newborn Using Kramer’s Criteria

  https://www.omicsonline.org/open-access/detection-of-neonatal-jaundice-among-the-newborn-using-kramers-criteria-2161-1165-1000355-105754.html

  The major conclusion drawn from the study was that the result shows that Out of 80 babies, 20 babies had Neonatal Jaundice, total incidence rate was 25%. There is a significant association found with the demographic variables like colostrums intake which is the one of the risk factor for Neonatal jaundice towards the Post test scores. Due to lack of early initiation of Breast feeding and delayed intake of colostrum at birth leads to Neonatal jaundice. Hence the above result concluded that the present study is that screening for Neonatal jaundice using Kramers criteria is a suitable low-cost and a feasible alternative modality for early detection of neonatal jaundice in a poor setting.

• #62 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.

• #63 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.

• #64 The Epidemiology of Neonatal Hyperbilirubinemia | Obgyn Key

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

  In order to develop an approach to the diagnosis and management of the jaundiced newborn, it is necessary to understand the nonpathologic factors that can affect bilirubin levels in the normal newborn infant as well as the natural history of neonatal bilirubinemia. Many factors have been identified in large epidemiologic studies as having some effect on neonatal bilirubin levels, but their clinical relevance is often questionable. Those that have been shown in recent studies to have an important influence on total serum bilirubin (TSB) levels are listed in Table 6-1. […] Mean maximum TSB concentrations in East Asian, Native American, and some Hispanic infants (primarily those of Mexican descent) are significantly higher than those in white infants. In a study of Hispanic infants, 31% had peak TSB levels 15 mg/dL compared with 310% of infants in other US populations. The mechanisms responsible for these differences are unknown, although there is some evidence that in the Native American population, increased bilirubin production plays a role. Black infants in the United States and Great Britain have lower TSB levels than white infants.

• #65 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.

• #66 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.

• #67 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). […] High bilirubin levels can cause significant harm including brain damage. It is therefore important that jaundice is diagnosed and treated in a timely way. This relies on visual signs of jaundice being present and observed by clinical staff. 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. […] 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.

• #68 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 lack of awareness among health care workers in maternity settings about bilirubin biology and its potential for neurotoxicity and the absence of set protocols for predischarge examination and follow-up instructions regarding jaundice in low-income health care facilities in our country are similar to problems prompting revision of the AAP guidelines in the United States in 2004. […] This 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.

• #69

  https://link.springer.com/article/10.1007/s12519-020-00347-3

  The outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV) has become a most challenging health emergency. […] Owing to rigorous quarantine and control measures taken in China, routine neonatal health surveillance and follow-up have become challenging. […] Without follow-up surveillance, some rapid and progressive newborn diseases, such as bilirubin encephalopathy, may be ignored. […] The characteristics of onset age of kernicterus suggest that monitoring of bilirubin level at home provides a useful way to alert hospital visits and to prevent the development of extremely hyperbilirubinemia. […] The aim is to make our management strategies of neonatal jaundice tailored to the infection prevention and control during the COVID-19 epidemic. […] Neonatal out-patient visits are of utmost important to those with hyperbilirubinemia.

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