Abstract

A NARRATIVE REVIEW ON NEONATAL JAUNDICE

Rinie Sonam Dsouza*, Sudhamshu K. Tantry, Krishnananda Kamath and A. R. Shabaraya

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Abstract

Neonatal jaundice is a prevalent condition characterized by yellow discoloration of the skin, sclera, and mucous membranes due to elevated total serum bilirubin (TSB) levels. Affecting approximately 60% of full-term and 80% of preterm infants, neonatal jaundice is typically benign but can lead to severe complications if not managed appropriately. Prolonged jaundice can result in kernicterus and bilirubin encephalopathy, necessitating prompt medical intervention. The aim was to provide a brief review on the etiology, epidemiology, clinical manifestations, risk factors, diagnostic methods and management strategies of neonatal jaundice. Unconjugated hyperbilirubinemia is most often physiological but can also be pathological due to factors such as hemolysis (e.g., ABO/Rh incompatibility, G6PD deficiency) or genetic disorders (e.g., Gilbert syndrome). Conjugated hyperbilirubinemia, less common but always pathological, is primarily caused by hepatobiliary dysfunctions such as biliary atresia or genetic syndromes. Clinical manifestations range from mild yellowing of the skin to severe symptoms like lethargy and high-pitched crying. Early diagnosis through physical examination, bilirubin level measurement, and risk assessment is critical. Treatment strategies include enhanced nutrition, phototherapy, exchange transfusion and intravenous immunoglobulin (IVIg), depending on the severity and underlying cause. Phototherapy remains the mainstay for treating hyperbilirubinemia, while exchange transfusion and IVIg are reserved for severe cases, particularly those involving immune-mediated hemolysis. While neonatal jaundice is common and usually benign, early detection and appropriate pathological, is primarily caused by hepatobiliary dysfunctions such as biliary atresia or genetic syndromes. Clinical manifestations range from mild yellowing of the skin to severe symptoms like lethargy and high-pitched crying. Early diagnosis through physical examination, bilirubin level measurement, and risk assessment is critical. Treatment strategies include enhanced nutrition, phototherapy, exchange transfusion and intravenous immunoglobulin (IVIg), depending on the severity and underlying cause. Phototherapy remains the mainstay for treating hyperbilirubinemia, while exchange transfusion and IVIg are reserved for severe cases, particularly those involving immune-mediated hemolysis. While neonatal jaundice is common and usually benign, early detection and appropriate management are vital to prevent severe complications. Continued research and education are essential to optimize outcomes for affected infants.

Keywords: Neonatal jaundice, hyperbilirubinemia, bilirubin, phototherapy, exchange transfusion.