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Neonatal Jaundice

When Is it Physiologic?

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Diseases of the Liver and Bile Ducts

Part of the book series: Current Clinical Practice ((CCP))

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Abstract

Virtually all infants develop hyperbilirubinemia with serum bilirubin levels of at least 1.4 mg/dL (24 μmnol/L) in the first 7 d of life. Clinically apparent jaundice develops in greater than one third of healthy newborns. In most cases, the jaundice is “physiologic” or associated with breast-feeding (1). Physiologic jaundice is generally defined as a benign increase in serum unconjugated bilirubin in newborns. Clinically apparent jaundice does not appear before 36 h of age, total serum bilirubin levels do not generally exceed 12 mg/dL (204 μmol/L), and clinical jaundice resolves within 7–10 d. Conjugated bilirubin does not exceed 2 mg/dL (34 μmol/L). Practitioners caring for newborns must recognize the clinical and laboratory features of jaundice which are “pathologic,” leading to appropriate diagnosis and management. The morbidity and mortality associated with neonatal jaundice can be attributed to the underlying disease process, as well as from the neurologic sequelae of kernicterus. These complications are largely preventable with timely diagnosis and treatment.

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References

  1. Maisels MJ, Gifford K. Normal serum bilirubin in the newborn and the effect of breast-feeding. Pediatrics 1986;78:837–843.

    PubMed  CAS  Google Scholar 

  2. Gourley GR. Jaundice. In: Wyllie R, Hyams JS, eds. Pediatric gastrointestinal disease, 1st ed. Saunders, Philadelphia, 1993, pp. 293–308.

    Google Scholar 

  3. Gourley GR. Bilirubin metabolism and neonatal jaundice. In: Suchy FJ, ed. Liver disease in children, 1st ed. Mosby, St. Louis, 1994, pp. 105–125.

    Google Scholar 

  4. Ebbesen F, Foged N, Brodersen R. Reduced albumin binding of MADDS-a measure of bilirubin binding-in sick children. Acta Paediatr Scand 1986;75:550–554.

    Article  PubMed  CAS  Google Scholar 

  5. Berk PD, Stremmel W. Hepatocellular uptake of organic anions. In: Popper H, Schaffner F, eds. Progress in liver diseases, vol. VIII. Grune and Stratton, New York, 1987, pp. 125–144.

    Google Scholar 

  6. Levi AJ, Gatmaitan Z, Arias IM. Two hepatic cytoplasmic protein fractions, Y and Z and their possible role in the hepatic uptake of bilirubin, sulfobromophthalein and other anions. J Clin Invest 1969;48:2156–2167.

    Article  PubMed  CAS  Google Scholar 

  7. Kawade N, Onishi S. The prenatal and postnatal development of UDP-glucuronyl-transferase activity towards bilirubin and the effect of premature birth on this activity in the human liver. Biochem J 1981; 196:257–260.

    PubMed  CAS  Google Scholar 

  8. Poland RL, Odell GB. Physiologic jaundice: the enterohepatic circulation of bilirubin. N Engl J Med 1971;284:1–6.

    Article  PubMed  CAS  Google Scholar 

  9. Rosta J, Makoi Z, Kertesz A. Delayed meconium passage and hyperbilirubinemia. Lancet 1986;2:1138.

    Google Scholar 

  10. Kramer LI. Advancement of dermal icterus in the jaundiced newborn. Am J Dis Child 1969; 118:454–458.

    PubMed  CAS  Google Scholar 

  11. Gartner LM. On the question of the relationship between breastfeeding and jaundice in the first 5 days. Sem Perinatol 1994; 18:502–509.

    CAS  Google Scholar 

  12. Gourley GR. The pathophysiology of breast milk jaundice. In: Polin RA, Fox WW, eds. Fetal and neonatal physiology. Grune and Stratton, New York, 1992, pp. 1173–1179.

    Google Scholar 

  13. Clarke CA. Prevention of Rh-hemolytic disease. Br Med J 1967;4:484–485.

    Article  PubMed  CAS  Google Scholar 

  14. Crigler JF, Najjar VA. Congenital familial nonhemolytic jaundice. Pediatrics 1952; 10:169–180.

    PubMed  Google Scholar 

  15. Arias IM, Wolfson S, Lucey JF, et al. Transient familial neonatal hyperbilirubinemia. J Clin Invest 1956;44:1442–1450.

    Article  Google Scholar 

  16. Odell GB, Gourley GR. Hereditary hyperbilirubinemia. In: Lebenthal E, ed. Textbook of gastroenterology and nutrition in infancy, 2nd ed. Raven Press, New York, 1989, pp. 947–967.

    Google Scholar 

  17. Thompson GN, McCrossin RB, Penfold JL, et al. Management and outcome of children with congenital hypothyroidism detected on neonatal screening in South Australia. Med J Aust 1986; 145:18–22.

    PubMed  CAS  Google Scholar 

  18. American Academy of Pediatrics Practice Parameter: management of hyperbilirubinemia in the healthy term newborn. Pediatrics 1994; 94:558–565.

    Google Scholar 

  19. American Academy of Pediatrics Practice Parameter: management of hyperbilirubinemia in the healthy term newborn, published erratum. Pediatrics 1995;95:458–461.

    Google Scholar 

  20. National Institute of Child Health Human Development randomized, control trial of phototherapy for neonatal hyperbilirubinemia. Pediatrics 1985;75(supp):385–441.

    Google Scholar 

  21. Ennever JF. Blue light, green light, white light, more light: treatment of neonatal jaundice. Clin Perinatol 1990; 17:467–481.

    PubMed  CAS  Google Scholar 

  22. Ennever JF, Costarino AT, Polin RA, et al. Rapid clearance of a structural isomer of bilirubin during phototherapy. J Clin Invest 1987;79:1674–1678.

    Article  PubMed  CAS  Google Scholar 

  23. Maisels MJ. Jaundice. In: Avery GB, Fletcher MA, MacDonald MG, eds. Neonatology, 4th ed. Lippincott, Philadelphia, 1994, pp. 630–725.

    Google Scholar 

  24. Stevenson DK, Rodgers PA, Vreman HJ. The use of metalloporphyrins for the chemoprevention of neonatal jaundice. Am J Dis Child 1989;143:353–356.

    PubMed  CAS  Google Scholar 

  25. Torres-Torres M, Tayaba R, Weintraub A, Holzman IR. New perspectives of neonatal hyperbilirubinemia. Mt Sinai J Med 1994;61:424–428.

    PubMed  CAS  Google Scholar 

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© 1998 Springer Science+Business Media New York

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Justinich, C.J., Hyams, J.S. (1998). Neonatal Jaundice. In: Wu, G.Y., Israel, J. (eds) Diseases of the Liver and Bile Ducts. Current Clinical Practice. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-4612-1808-1_22

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  • DOI: https://doi.org/10.1007/978-1-4612-1808-1_22

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-4612-7293-9

  • Online ISBN: 978-1-4612-1808-1

  • eBook Packages: Springer Book Archive

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