Incidence, Course, and Prediction of Hyperbilirubinemia in Near-Term and Term Newborns

Abstract

Near-term newborns should not be treated as term newborns in the approach to management of hyperbilirubinemia, because infants of 35 to 37 weeks' gestation had significantly lower birth weights, significantly higher serum total bilirubin levels on days 5 and 7, and were 2.4 times more likely to develop significant hyperbilirubinemia than those of 38 to 42 weeks' gestation in the present study. In near-term newborns of 35 to 37 weeks' (245 to 265 days') gestation, the decision to diagnose and treat significant hyperbilirubinemia should be made on the basis of risk status (percentile distribution of the serum bilirubin values on postnatal age) rather than using birth-weight-based thresholds. A nomogram constructed from daily serum bilirubin values of each population, as we present herein, can be used in assessing the age (hour)-specific jaundice risk (high, intermediate, or low) of each near-term newborn.

Cord Serum Bilirubin Level in Predicting the Development of Significant Hyperbilirubinemia in Newborns with ABO Incompatibility

“…Thus all new borns should be considered for screening irrespec ve of sex and mode of delivery. This was consistent with observa ons of S Umit et al 12,17 and Frauk Aplay et al 4 Birth weight did not have any bearing on the development of signifi cant jaundice. Mean birth wt.…”

“…4 S Umit Sarici et al reported birth weight of 2794±418gm and 2772±157gm in two groups. 17 S Umit et al observed mean birth weight of 3214±828gmgm and 3212± 196 gm in two groups 12 .…”

Saying “No” to Induction

“…The near-term infant is at increased risk for temperature instability, hypoglycemia, respiratory distress, apnea and bradycardia, and clinical jaundice (Wang et al, 2004). The baby's difficulty in coordinating suck/swallow and breathing abilities contributes to problems with feeding; subsequently, poor feeding adds an increased risk of hyperbilirubinemia (Sarici et al, 2004). Near-term infants are 2.4 times more likely than full-term infants to develop significant hyperbilirubinemia (Sarici et al, 2004).…”

“…The baby's difficulty in coordinating suck/swallow and breathing abilities contributes to problems with feeding; subsequently, poor feeding adds an increased risk of hyperbilirubinemia (Sarici et al, 2004). Near-term infants are 2.4 times more likely than full-term infants to develop significant hyperbilirubinemia (Sarici et al, 2004). Even ''well'' near-term infants who have a normal hospital stay are at increased risk for hospital readmittance, most frequently due to inadequate feeding and to jaundice (Bhutani et al, 2004;Escobar et al, 2005;Wang et al, 2004 Burus-Frank, & Santa-Donato, 2005) is an excellent summary of the problem, the research, and practice implications.…”

Transcutaneous Billirubinometry: A Useful Screening Tool for Neonatal Jaundice in Term and Near Term Babies - A Hospital Based Study

“…2 Significant jaundice is found in 10.5% of term and 25.3% of late preterm infants. 3,4 Therefore each case must be evaluated to detect at risk babies and follow up should be continued even after discharge from hospital as bilirubin level may vary over time and may not peak until 5 th day of life or later to prevent significant morbidity. 2 The gold standard for measurement of billirubin level in newborn is total serum billirubin estimation (TSB).…”