Jaundice in the healthy term neonate: When is treatment indicated?

Abstract

ne of the most common problems seen in the term neonate is jaundice. Approximately two thirds of newborns become clinically jaundiced. There continues to be controversy about the potential adverse effects of neonatal jaundice in the healthy term neonate, and when to initiate treatment. For this discussion, term is defined as 37 or more completed weeks of gestation. Definition Clinical jaundice is defined as the visible manifestation of chemical hyperbilirnbinemia. 1 It is unusual to recognize jaundice clinically until the serum bilirubin concentration exceeds 7 mg/dl. Bilirubin Formation and Excretion Bilirubin is derived from the catabolism of heme proteins. It is primarily caused by destruction of hemoglobin derived from senescent red blood cells. The catabolism of 1 gm of hemoglobin results in the production of 34 mg of bilirubin. The normal newborn produces 8.5 ± 2.3 mg of bilirubin/kg/day.