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In newborns, jaundice tends to develop because of two factors—the breakdown of fetal hemoglobin as it is replaced with adult hemoglobin and the relatively immature metabolic pathways of the liver, which are unable to conjugate and so excrete bilirubin as quickly as an adult.
Jaundice in newborns is usually transient and dissipates without medical intervention. In cases when serum bilirubin levels are greater than 4–21 mg/dl (68–360 μmol/L), infant may be treated with phototherapy or exchanged transfusion depending on the infant's age and prematurity status. [ 9 ]
[citation needed] Diagnosis is usually made by investigation of a newborn baby who has developed jaundice during the first week of life. Testing. Coombs - after birth, the newborn will have a direct Coombs test run to confirm antibodies attached to the infant's red blood cells. This test is run from cord blood. [5]
Some infected neonates will develop acute hepatitis B and symptomatically will develop abdominal distension, jaundice, clay- colored stools and failure to thrive. However, most infected neonates will be asymptomatic but will chronically have persistent hepatitis B surface antigens in the blood and elevated transaminase levels.
Following a specific trigger, symptoms such as yellowish skin, dark urine, shortness of breath, and feeling tired may develop. [1] [2] Complications can include anemia and newborn jaundice. [2] Some people never have symptoms. [3] It is an X-linked recessive disorder that results in defective glucose-6-phosphate dehydrogenase enzyme. [1]
Hemolytic disease of the newborn, also known as hemolytic disease of the fetus and newborn, HDN, HDFN, or erythroblastosis fetalis, [1] [2] is an alloimmune condition that develops in a fetus at or around birth, when the IgG molecules (one of the five main types of antibodies) produced by the mother pass through the placenta.
Physiologic jaundice can be a benign condition that presents in newborns until two weeks of life. [2] However, jaundice that continues after two weeks requires follow up with measurement of total and conjugated bilirubin. [3] Elevated levels of conjugated bilirubin are never benign and require further evaluation for neonatal cholestasis. [3]
More than 80% of newborns develop jaundice within several days of birth. [40] Jaundice, or yellowing of the skin and eyes, occurs when bilirubin, a byproduct of the breakdown/recycling of red blood cells, builds up in the newborn's bloodstream faster than the liver can break it down and excrete it through the baby's urine and stool.