Neonatal jaundice: frequent clinical manifestation in pediatrics

Abstract

Neonatal jaundice consists of the appearance of yellowish discoloration in the skin and mucous membranes, particularly in the sclera, which occurs during the first days of a newborn's life and is considered one of the most frequent reasons for consultation in neonatal period.

This condition is due to excess bilirubin in the blood, which accumulates in the tissues when its serum levels exceed a certain threshold.

According to estimates, globally there are around 481,000 cases of hyperbilirubinemia and jaundice in newborns each year, of which approximately 63,000 survive but are left with severe chronic disability.

Various factors have been identified that increase the risk of developing jaundice in newborns, the most relevant being prematurity, breastfeeding, the male gender, a gestational age of less than 37 weeks, the presence of extravasated blood and the reabsorption of hematomas such as cephalohematoma, increased red cell mass in case of polycythemia, increased enterohepatic circulation, intrauterine infections, ABO or Rh incompatibility, untreated maternal urinary tract infections, and neonatal sepsis.

It is recommended to carefully examine the skin to detect the level and extent of yellowing, which indicates jaundice, whose levels may be greater than 5 mg/dL of bilirubin. It is also important to observe if the neonate presents plethora, macrosomia, or any hematoma on the head.

The diagnosis of neonatal jaundice caused by hyperbilirubinemia is commonly suspected by yellowing of the newborn but must be confirmed by measurement of serum bilirubin levels, although transcutaneous measurement is now also used. Phototherapy and exchange transfusion are used to treat it.