Neonatal jaundice (NJ) accounts for a majority of the medical intervention in the newborn period. Although transitory hyperbilirubinemia (HB) is common among newborns, it should be detected by a trained observer in good lighting. Incidence of neonatal jaundice has been reported between 60% to more than 90%.

Bilirubin is formed as the end product after disassembly of heme-containing molecules, primarily hemoglobin. Thus conditions increasing hemolysis will also increase bilirubin and manifest as jaundice. It is common in conditions like- blood group incompatibilities and congenital hemolytic anaemias in neonates. 

A family history of NJ makes the newborn susceptible to jaundice and thus proves genetic conditions to contribute. Apart, Endocrine and metabolic conditions are also known to contribute, the most common being maternal diabetes. Drugs consumption by a pregnant mother may have an impact on the hepatic metabolism of bilirubin in the newborn, by reducing the incidence of jaundice. This even seems true for certain drugs given to the newborn. 

Birth trauma causing extravasation of blood increases increase bilirubin production and jaundice. Immature bilirubin metabolism is found in Preterm infants and thus a higher incidence of jaundice. Even breastfed infants have shown an increased incidence of jaundice, which lasts longer. 

Extreme NJ is associated with the risk of kernicterus spectrum syndrome, which affects about 99/100,000 or more children globally. This accounts for nearly 130,000 or more infants each year, which demands increased vigilance and preparedness for rapid therapeutic intervention.

Reference: Hansen TWR. The epidemiology of neonatal jaundice. Pediatric Medicine,2021;4