Etiologies and Initial Evaluation of Neonatal Jaundice

Neonatal jaundice is seen in up to 60% of full-term infants and 80% of preterm infants during the first week of life. While it is often considered as a single clinical entity, neonatal jaundice is a physical finding associated with many possible etiologies. Jaundice is observed when the pigment bilirubin accumulates in the skin, sclera and other tissues. The importance of correctly identifying the etiology of neonatal jaundice lies in the necessity of intervening early to avoid the devastating sequelae of prolonged hyperbilirubinemia, namely bilirubin-induced neurological dysfunction (BIND), formerly kernicteruskernicterus. This manuscript provides a framework for thinking about the etiologies of neonatal jaundice with respect to type of hyperbilirubinemia (direct vs. indirect) and age of the newborn.