Neonatal Hyperbilirubinemia: Complications, Treatment, Symptoms, Causes

Neonatal Hyperbilirubinemia

Neonatal hyperbilirubinemia is an elevated level of bilirubin in newborns. Bilirubin is produced when old red blood cells are broken down by the body's natural processes. This condition can lead to kernicterus, which involves permanent damage to the brain due to high levels of unconjugated bilirubin. Here we cover the complications, treatment, symptoms, and causes of this condition.

Complications of Neonatal Hyperbilirubinemia

Complications from neonatal hyperbilirubinemia can result in kernicterus, which includes problems such as hearing loss, developmental delays, seizure disorders, cerebral palsy, optic atrophy, choreoathetoid cerebral palsy, intellectual disability, and varying degrees of mental retardation.

Treatment of Neonatal Hyperbilirubinemia

Treatment options for neonatal hyperbilirubinemia depend on the severity of jaundice or liver dysfunction. Less severe cases may only require monitoring, while more severe cases might need phototherapy or exchange transfusion. Phototherapy uses light to break up bilirubin into simpler compounds that can be easily eliminated via urine or feces. In some instances, an exchange transfusion may be necessary, where a portion of the baby's blood is replaced with donor blood containing normal levels of bilirubin.

Symptoms of Neonatal Hyperbilirubinemia

Symptoms of neonatal hyperbilirubinemia usually appear within three days to two weeks after birth. They can include yellowing of the skin and eyes (icterus), dehydration because of fluid replacement for infants who vomit frequently, feeding difficulty due to poor suck reflexes, hypotonia (floppy baby syndrome), lethargy, tremors, seizures, deep sleepiness, high-pitched cry, irritability, stiffness, and fever.

Causes of Neonatal Hyperbilirubinemia

Causes of neonatal hyperbilirubinemia may include breastfeeding difficulties leading to delayed feedings, rhesus disease (Rh incompatibility between mother and fetus), glucose-6 phosphate dehydrogenase (G6PD) deficiency in mother or baby, infections (such as bacterial infection causing hemolysis), abnormalities of bilirubin metabolism (e.g., galactosemia).