Neonatal Jaundice: Causes and Risks

Definition and Incidence

• Neonatal jaundice is a common condition in newborns characterized by yellowish discoloration of the skin and eyes due to elevated bilirubin levels in the blood.
• Affects approximately 60% of full-term and 80% of preterm infants.

Causes and Risk Factors

• Physiological jaundice: occurs in 50-60% of full-term infants, usually appears on day 2-3, and resolves by day 7-10.
• Breast milk jaundice: associated with breastfeeding, may persist for several weeks.
• Hemolytic disease of the newborn (Rh incompatibility): rare, but severe, type of jaundice.
• Other risk factors:
  • Premature birth
  • Family history of jaundice
  • Polycythemia (excessive red blood cell production)
  • Infections (e.g., UTIs, sepsis)

Signs and Symptoms

• Yellow discoloration of:
  • Skin (starts on face, progresses to trunk, arms, and legs)
  • Sclera (whites of the eyes)
• May be accompanied by:
  • Lethargy
  • Poor feeding
  • Vomiting
  • Dark urine

Diagnosis and Treatment

• Total serum bilirubin (TSB) levels: measure bilirubin levels in the blood.
• Phototherapy: exposure to special lights that help break down bilirubin.
• Exchange transfusion: rare, but may be necessary for severe cases.
• Supportive care:
  • Fluid and electrolyte management
  • Monitoring for complications (e.g., kernicterus)

Complications and Prognosis

• Kernicterus: rare, but serious, complication characterized by bilirubin-induced brain damage.
• Hearing loss
• Neurodevelopmental delays
• Increased risk of mortality
• In most cases, neonatal jaundice resolves spontaneously, with a good prognosis.

Definition and Incidence

• Neonatal jaundice is a condition characterized by yellowish discoloration of the skin and eyes due to elevated bilirubin levels in the blood.
• It affects approximately 60% of full-term and 80% of preterm infants.

Causes and Risk Factors

• Physiological jaundice occurs in 50-60% of full-term infants, appearing on day 2-3 and resolving by day 7-10.
• Breast milk jaundice is associated with breastfeeding and may persist for several weeks.
• Hemolytic disease of the newborn (Rh incompatibility) is a rare, but severe, type of jaundice.
• Other risk factors include:
  • Premature birth
  • Family history of jaundice
  • Polycythemia (excessive red blood cell production)
  • Infections (e.g., UTIs, sepsis)

Signs and Symptoms

• Yellow discoloration of the skin (starts on face, progresses to trunk, arms, and legs)
• Yellow discoloration of the sclera (whites of the eyes)
• May be accompanied by:
  • Lethargy
  • Poor feeding
  • Vomiting
  • Dark urine

Diagnosis and Treatment

• Total serum bilirubin (TSB) levels measure bilirubin levels in the blood.
• Phototherapy involves exposure to special lights that help break down bilirubin.
• Exchange transfusion is a rare, but necessary, treatment for severe cases.
• Supportive care includes:
  • Fluid and electrolyte management
  • Monitoring for complications (e.g., kernicterus)

Complications and Prognosis

• Kernicterus is a rare, but serious, complication characterized by bilirubin-induced brain damage.
• Other potential complications include:
  • Hearing loss
  • Neurodevelopmental delays
  • Increased risk of mortality
• In most cases, neonatal jaundice resolves spontaneously, with a good prognosis.