Skip to Main Content

++

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,1 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.

++
Table Graphic Jump Location
Table 6-1. Risk Factors for the Development of Hyperbilirubinemia in Infants of 35 or More Weeks Gestation 
++

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.26 In a study of Hispanic infants, 31% had peak TSB levels >15 mg/dL6 compared with 3–10% of infants in other US populations.7,8 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.5 Black infants in the United States and Great Britain have lower TSB levels than white infants.3,911

++

Neonatal jaundice runs in families. Khoury et al.12 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.13,14

++

The genetics of neonatal jaundice and ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessPediatrics Full Site: One-Year Subscription

Connect to the full suite of AccessPediatrics content and resources including 20+ textbooks such as Rudolph’s Pediatrics and The Pediatric Practice series, high-quality procedural videos, images, and animations, interactive board review, an integrated pediatric drug database, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPediatrics

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.