Neonatal jaundice screening

Neonatal jaundice is a yellow discoloration of the skin of newborns which appears as a result of the imbalance between bilirubin production and elimination. It occurs in 60-85% of newborns and in majority of cases resolves within a few days. However, misdiagnosis of pathologic neonatal jaundice as benign physiologic jaundice delays the detection of potentially serious medical conditions or complications. High levels of unconjugated bilirubin in blood exert a neurotoxic effect on the central nervous system, leading to bilirubin encephalopathy, while conjugated hyperbilirubinemia indicates potentially serious hepatic disorder or a systemic illness. Unfortunately, severe neonatal jaundice is still recognized as a “silent” cause of numerous cases of neonatal morbidity and mortality worldwide. Therefore, the goal of neonatal jaundice screening programs is the prompt detection of the neonatal jaundice cases, giving extra time to health care personel for preemptive actions with an aim of reducing infant’s mortality and morbidity caused by severe hyperbilirubinemia. The objective of this paper is giving an overview of neonatal jaundice, including its pathophysiology and etiology, clinical manifestations and complications associated with it, management and interventions as well as current guidelines and recommendations for screening and management with a short review of technical advances in the area. Ultimately the aim of the paper includes a proposal for a novel approach to early detection of neonatal jaundice.