Guidelines for management of the jaundiced term and near-term infant.
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.
University of Pennsylvania School of Medicine, Philadelphia, USA.
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Johnson
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Bhutani
D000359:Aftercare / Q000191:economics / Q000379:methods; D001663:Bilirubin / Q000097:blood; D001942:Breast Feeding / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D006801:Humans; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D007902:Length of Stay / Q000706:statistics & numerical data; D015997:Neonatal Screening; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
D001663:Bilirubin