Table 2Risk Factors for the Development of Severe Hyperbilirubinemia

Major risk factors:
  • Predischarge bilirubin level in the high-risk zone on Bhutani nomogram (Appendix 1)
  • Visible jaundice in the first 24 hours of life
  • Blood group incompatibility with positive direct antiglobulin test* (A neonate should NOT be presumed to have ABO incompatible hemolytic disease solely on the basis of maternal blood type O.)
  • Known hemolytic disease (eg, G6PD deficiency) *
  • Gestational age < 37 weeks
  • Previous sibling received phototherapy
  • Cephalohematoma or significant bruising
  • Exclusive breastfeeding
  • East Asian race
Minor risk factors:
  • Predischarge bilirubin level in the high intermediate-risk zone
  • Gestational age 37–38 weeks
  • Visible jaundice before discharge
  • Macrosomic neonate of a diabetic mother
  • Maternal age ≥ 25 years
  • Male gender
*

Also related to neurotoxicity risk factor, see neurotoxicity risk factors. (Certain risk factors increase likelihood of severe hyperbilirubinemia, others increase neurotoxicity risks; some risk factors increase both.)

From: Management of Indirect Neonatal Hyperbilirubinemia

Cover of Management of Indirect Neonatal Hyperbilirubinemia
Management of Indirect Neonatal Hyperbilirubinemia [Internet].
Sroufe NS, Vredeveld JL, Goodson SL, et al.
Ann Arbor (MI): Michigan Medicine University of Michigan; 2020 Jun.
© Regents of the University of Michigan.

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