A simple test can accurately identify which newborn babies are at risk for developing dangerous levels of jaundice, according to researchers at The Children's Hospital of Philadelphia.
While neonatal jaundice, a yellowing of the skin caused by a buildup of a blood product called bilirubin, is common in newborns and usually disappears on its own, it can progress to brain damage in a small fraction of cases.
The American Academy of Pediatrics currently recommends two options, used alone or in combination, to assess an infant’s risk of developing severe hyperbilirubinemia: a predischarge measurement of the bilirubin level and a screening checklist of risk factors such as intended method of feeding, siblings with history of jaundice, and race.
The Children's Hospital researchers say that the predischarge bilirubin measurement, combined with the baby's gestational age, is the most accurate method for predicting whether the newborn is at risk.
Their findings are published in the January 2008 issue of the journal Pediatrics. Children’s Hospital physicians studied outcomes for 823 newborns admitted to the Hospital of the University of Pennsylvania in Philadelphia between September 2004 and October 2005.
“The challenge facing every pediatrician who takes care of newborn babies is to identify those infants they send home that will develop a bilirubin level that could cause injury,” said Ron Keren, M.D., M.P.H., a pediatrician at Children’s Hospital and the lead author of the study. “We found that by measuring the bilirubin in every baby, and combining that information with the baby’s gestational age, you could accurately predict which infants are at very high risk and which ones are at very low risk.”
This screening method should allow pediatricians to determine which newborns should stay in the hospital for monitoring, which may go home and return the next day for another test and which don’t need any additional follow-up for jaundice. About 70 percent of babies fell into the low-risk category, while 13 percent were designated high risk and 17 percent were in the middle, said Keren.