Jaundice that appears in a newborn <24 hour old is most likely nonphysiologic and needs further evaluation.
Jaundice typically presents on the 2nd-3rd day of life. It is usually first seen on the face and forehead then progresses caudally to the trunk and extremities.
Visible jaundice in the feet may be an indication to check bilirubin level.
Visual estimation of bilirubin level is often inaccurate and unreliable.
Danger signs in a newborn infant with jaundice includes changes in brainstem evoked auditory potentials, changes in muscle tone, seizures and altered cry characteristics.
The presence of any of the danger signs require prompt attention to prevent kernicterus.
Bili-ruler, a simple, low-cost icterometer, may help improve the objectivity of visual examination for hyperbilirubinemia in neonates, with a recent study showing that the device can accurately identify different clinically relevant thresholds of the condition.
A technology based on analysis of images taken using a smartphone provides acceptable estimates of total serum bilirubin levels in newborn infants, with an accuracy that does not differ from that of transcutaneous bilirubin measurement, according to a US study.
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Infants with low Apgar scores within the normal range (7–10) are at increased risks of neonatal mortality and morbidity, according to a study in Sweden. Compared with infants with stable Apgar scores of 10, those with a decrease in score from 5–10 minutes are also at higher risk of morbidity.
Maternal exposures to heavy metals vanadium (V), arsenic (As) and lead (Pb) at early pregnancy appear to result in lower maternal free T3 (FT3) and FT3/free T4 (FT4) ratio, which may contribute to reduced birthweight, suggests a recent study.