Neonatal jaundice

Overview

Abstract | Cite as | Substantive changes

Abstract

INTRODUCTION: About 50% of term and 80% of preterm babies develop jaundice, which usually appears 2 to 4 days after birth, and resolves spontaneously after 1 to 2 weeks. Jaundice is caused by bilirubin deposition in the skin. Most jaundice in newborn infants is a result of increased red cell breakdown and decreased bilirubin excretion. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for unconjugated hyperbilirubinaemia in term and preterm infants? We searched Medline, Embase, The Cochrane Library, and other important databases up to February 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 42 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following interventions: albumin infusion, exchange transfusion, home phototherapy, immunoglobulin, hospital phototherapy, and tin-mesoporphyrin.

Cite as

Woodgate P and Jardine LA. Neonatal jaundice. Clinical Evidence 2011; 09:319.

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Substantive changes

Hospital phototherapy New evidence added.[10][15][16][17][18][19][20][22][23][24][25][26][27][28][29][30][31][33][32][34] Categorisation unchanged (Beneficial).

Exchange transfusion New evidence added.[36] Categorisation unchanged (Likely to be beneficial by consensus) because new evidence comparing single volume exchange transfusion (SVET) versus double volume exchange transfusion (DVET) was insufficient to judge the effects of these interventions.

Immunoglobulin New option added with one systematic review[44] and 4 RCTs.[42][43][45][46] Categorised as beneficial.

Latest guidelines

Latest citations

Hemolysis and hyperbilirubinemia in antiglobulin positive, direct ABO blood group heterospecific neonates. ( 13 November 2014 )

Dose-Response Relationship of Phototherapy for Hyperbilirubinemia. ( 13 November 2014 )