Document Detail

Assessing jaundice in infants of 35-week gestation and greater.
MedLine Citation:
PMID:  20463489     Owner:  NLM     Status:  MEDLINE    
PURPOSE OF REVIEW: In 2004, the American Academy of Pediatrics officially recommended universal predischarge risk assessment for severe neonatal hyperbilirubinemia with the goal of minimizing subsequent risk of chronic bilirubin encephalopathy (formerly known as kernicterus). In this article, we review recent research regarding jaundice predischarge risk assessment, current expert recommendations for universal predischarge bilirubin screening, and concerns expressed in the literature regarding these recommendations. RECENT FINDINGS: A group of experts have recently recommended universal predischarge bilirubin screening to identify newborns at risk for developing severe neonatal hyperbilirubinemia. In contrast, the United States Preventive Services Task Force states that there is insufficient evidence to make this recommendation. Transcutaneous bilirubinometry has emerged as a noninvasive, quick method to screen for neonatal hyperbilirubinemia, although refinement and validation of transcutaneous bilirubin nomograms are needed. Newer studies suggest that the combined use of a predischarge bilirubin and gestational age risk assessment offers a simple, objective, and accurate way to identify infants at risk for subsequent, severe hyperbilirubinemia. SUMMARY: All newborns should be systematically assessed for risk of developing severe hyperbilirubinemia prior to hospital discharge. Although limited data exist to recommend its use universally, predischarge bilirubin screening should be considered given recent expert opinion. The role of transcutaneous bilirubinometry remains promising, although further research evaluating and validating its use in varied and diverse populations is imperative. Combined models of risk assessment may offer the best approach to identifying infants at risk for subsequent, severe hyperbilirubinemia.
Meredith Lease; Bonny Whalen
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in pediatrics     Volume:  22     ISSN:  1531-698X     ISO Abbreviation:  Curr. Opin. Pediatr.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-13     Completed Date:  2010-08-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9000850     Medline TA:  Curr Opin Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  352-65     Citation Subset:  IM    
Department of Pediatrics, Dartmouth Medical School, Hanover, New Hampshire, USA.
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MeSH Terms
Gestational Age
Hyperbilirubinemia, Neonatal / complications,  diagnosis*,  therapy
Infant, Newborn
Kernicterus / etiology,  prevention & control
Neonatal Screening / methods*
Patient Discharge
Risk Assessment
Severity of Illness Index
United States

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