Guidelines for management of the jaundiced term and near-term infant

Clin Perinatol. 1998 Sep;25(3):555-74, viii.

Abstract

Factors believed to have contributed to the reemergence of kernicterus in the United States during the 1990's are discussed: these include decreased concern about toxicity of bilirubin in term and near-term infants, increased prevalence of breastfeeding, and increasingly shortened postnatal hospital stays. The rationale for a universal predischarge bilirubin measurement at the time of the routine predischarge metabolic screen is presented: the hour-specific level of bilirubin at discharge, plotted on an Hour-Specific Bilirubin Nomogram, improves prediction of risk of excessive jaundice postdischarge and facilitates safe, cost-effective follow-up. This minimizes repeat bilirubin measurements and maximizes recognition of confounding variables and risk of hyperbilirubinemia so that timely, minimally invasive, preventive therapy can be instituted if needed.

Publication types

  • Review

MeSH terms

  • Aftercare / economics
  • Aftercare / methods
  • Bilirubin / blood
  • Breast Feeding / statistics & numerical data
  • Cost-Benefit Analysis
  • Humans
  • Infant, Newborn
  • Jaundice, Neonatal / blood
  • Jaundice, Neonatal / diagnosis*
  • Jaundice, Neonatal / epidemiology
  • Jaundice, Neonatal / etiology
  • Jaundice, Neonatal / therapy*
  • Length of Stay / statistics & numerical data
  • Neonatal Screening
  • Risk Factors
  • United States / epidemiology

Substances

  • Bilirubin