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.