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.
Johnson
L
L
University of Pennsylvania School of Medicine, Philadelphia, USA.
Bhutani
V K
VK
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