Analysis of prolonged jaundice

Published Date: 19th July 2016

Publication Authors: Bentur H

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Background and aims 

Prolonged neonatal jaundice is a common presentation in newborns and rarely requires intervention; however it is important to rule out sinister causes such as biliary atresia. The outcome of this study was to analyse the demographics of infants presenting with prolonged jaundice, investigations undertaken and results of these tests in relation to NICE guidelines.

Methods 

We retrospectively identified infants over 2 years (January 2012 to December 2013) coded to have a prolonged jaundice screen. Analysing the case notes, 90 infants had a screen performed, from age 14 to 71 days of life, with an average of 21 days of life.

Results 

Of the infants screened, 18 (20%) patients were found to have abnormal initial results, with significant abnormalities in 3 (3.3%) patients. One infant who presented at day 71 of life was identified to have biliary atresia, one infant had a urinary tract infection, and one infant had a positive reducing sugar and confirmed to be lactose intolerant. Four patients had ABO incompatibility but were otherwise well.

Conclusion 

In our study, we found only one baby with conjugated hyperbilirubinaemia who presented late. The remainder of the babies investigated for prolonged jaundice were benign. Majority of the infants (72%) were breastfed, which is a well-recognised cause for prolonged jaundice. As such, the authors propose that in well babies with pigmented stools, performing the prolonged jaundice screen at 21 rather than 14 days could reduce the burden of carrying out unnecessary tests without causing significant detriment to these patients.

Hendriks, G; Gao, W; Bentur, H. (2014).  Analysis of prolonged jaundice in newborns: A study looking at the investigations performed and outcomes in a district general hospital . Archives of Disease in Childhood. 99 (Suppl 2), A132-A133.

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