Management of hyperbilirubinemia in near-term newborns according to American Academy of Pediatrics Guidelines: Report of three cases

  • Naomi Esthemita Dewanto
  • Rinawati Rohsiswatmo
Keywords: hyperbilirubinemia, newborns, American Academy of Pediatrics Guidelines

Abstract

All neonates have a transient rise in
bilirubin levels, and about 30-50% of
infants become visibly jaundiced.1,2
Most jaundice is benign; however,
because of the potential brain toxicity of bilirubin,
newborn infants must be monitored to identify
those who might develop severe hyperbilirubinemia
and, in rare cases, acute bilirubin encephalopathy
or kernicterus. Ten percent of term infants
and 25% of near-term infants have significant
hyperbilirubinemia and require phototherapy. 3
The American Academy of Pediatrics (AAP)
recommends procedures to reduce the incidence
of severe hyperbilirubinemia and bilirubin
encephalopathy, and to minimize the risks of
unintended harm such as maternal anxiety,
decreased breastfeeding, and unnecessary costs
or treatment.4
The guidelines provide a framework for the
prevention and management of hyperbilirubinemia
in newborn infants of 35 weeks or more of
gestational age (term and near-term newborns).
This case report details the management of three
newborns of 35 or more gestational age at the
Siloam Lippo Cikarang Hospital, Tanggerang, West
Java, Indonesia according to the AAP guidelines.

Author Biographies

Naomi Esthemita Dewanto
Department of Child Health, Siloam Lippo Cikarang Hospital, Tanggerang, Indonesia.
Rinawati Rohsiswatmo
Department of Child Health, Siloam Lippo Cikarang Hospital, Tanggerang, Indonesia.

References

I. Kenner C, Lott JW Hematologic Care. In: Kenner C, Lott
JW, editors. Neonatal nursing handbook. StLouis: Saunders;
2004; p. 354-86.
2. Mupanemunda R, Watkinson M. Jaundice. In: Mupanemunda
R, Watkinson M, editors. Key topics in neonatology, 2nd
edition. London: Taylor & Francis; 2005; p. 214-7.
3. Sarici SU, Serdar MA, Korkmaz A, Edrem G, Oran 0,
Tekinalp G, et al. Incidence, course, and prediction of
hyperbilirubinemia in near-term and term newborns.
Pediatrics. 2004;113:775-80.
4. American Academic of Pediatrics. Management of hyperbilirubinemia
in the newborn infant 35 or more weeks of
gestation. Pediatrics. 2004; 114:297 -3I6.
5. Porter ML, Dennis BL. Hyperbilirubinemia in the term
newborn. Am Fam Physician. 2002;65:599-6I4.
6. Dennery PA, Seidman DS, Stevenson DK. Neonatal
hyperbilirubinemia. N Eng! J Med. 2001;344:581-90.
7. Keren R, Bhutani VK. Predischarge risk assessment
for severe neonatal hyperbilirubinemia. Neo Reviews.
2007;8:E68-76.
8. Bhutani VK, Johnson L, Sivieri EM. Predictive ability of a
predischarge hour-specific serum bilirubin for subsequent
significant hyperbilirubinemia in healthy term and near-term
newborns. Pediatrics. 1999; 103:6-I4.
9. Kaplan M, Bromker R, Schimmel M, Algur N, Hammerman
C. Evaluation of discharge management in the prediction
of hyperbilirubinemia: the Jerusalem experience. J Pediatr.
2007;150:4I2-7.
10. Alkalay AL, Simmons CF. Hyperbilirubinemia guidelines in
newborn infants. Pediatrics. 2005: II5;824-5.
II. Martinez JC. Argentinean perspective of the 2004 AAP
hyperbilirubinemia guidelines. Indonesia: [update 2007
Oct 24]. AAP sponsored. Available from: http: //neoreviews.
aappublications.org.
I2. Gourley GR. Breasfeeding, diet, and neonatal hyperbilirubinemia.
NeoReviews. 2000; 1:25-30.
13. Huang MJ, Kua KE, Teng HC, Tang KS, Weng HW, Huang
CS, et al. Risk factors for severe hyperbilirubinemia in
neonates. Pediatr Res. 2004;56:682-9.
I4. Maruo Y, Niishizawa K, Sato H, Shimida M. Prolonged
unconjugated hyperbilirubinemia associated with breastmilk
and mutations of the bilirubin uridine diphosphateglucuronsyltransferase
gene. Pediatrics. 2000; I 06:59-62.
I5. Ip Stanley, Chung M, Kulig], eta!. An evidence-based review
of important issues concerning neonatal hyperbilirubinemia.
Pediatrics. 2004;114;el30-53.
I6. Harris MC, Bernbaum JC, Polin JR, Zimmerman R, Polin
RA. Developmental follow-up of breastfed term and nearterm
infants with marked hyperbilirubinemia. Pediatrics.
2001; 107: I075-80.
I7. Eggert LD, Wiedmeier SE, Wilson J, Chrisensen RD. The
effect of instituting a prehospital-discharge newborn bilirubin
screening program in an IS-hospital health system. Pediatrics.
2006; II7 :e855-62.
Published
2009-04-30
How to Cite
1.
Dewanto N, Rohsiswatmo R. Management of hyperbilirubinemia in near-term newborns according to American Academy of Pediatrics Guidelines: Report of three cases. PI [Internet]. 30Apr.2009 [cited 27Apr.2024];49(2):125-30. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/539
Section
Case Report
Received 2016-09-10
Accepted 2016-09-10
Published 2009-04-30