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Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation

TABLE 2.

Risk Factors for Development of Severe Hyperbilirubinemia in Infants of 35 or More Weeks’ Gestation (in Approximate Order of Importance)

Major risk factors
 Predischarge TSB or TcB level in the high-risk zone (Fig 2)25,31
 Jaundice observed in the first 24 h30
 Blood group incompatibility with positive direct antiglobulin test, other known hemolytic disease (eg, G6PD deficiency), elevated ETCOc
 Gestational age 35–36 wk39,40
 Previous sibling received phototherapy40,41
 Cephalohematoma or significant bruising39
 Exclusive breastfeeding, particularly if nursing is not going well and weight loss is excessive39,40
 East Asian race39*
Minor risk factors
 Predischarge TSB or TcB level in the high intermediate-risk zone25,31
 Gestational age 37–38 wk39,40
 Jaundice observed before discharge40
 Previous sibling with jaundice40,41
 Macrosomic infant of a diabetic mother42,43
 Maternal age ≥25 y39
 Male gender39,40
Decreased risk (these factors are associated with decreased risk of significant jaundice, listed in order of decreasing importance)
 TSB or TcB level in the low-risk zone (Fig 2)25,31
 Gestational age ≥41 wk39
 Exclusive bottle feeding39,40
 Black race38*
 Discharge from hospital after 72 h40,44
  • * Race as defined by mother’s description.