Normal value of jaundice in premature infants
Release time : 03/01/2025 11:57:31
At the time of a baby's birth, parents are informed about a series of data related to the infant's physical condition. One such data point is called the jaundice index.
What is the normal value for jaundice index in preterm infants? What exactly does it represent? Let's explore these questions together about jaundice index.
Neonatal jaundice is a common condition in newborns. Clinically, 60% of full-term infants show jaundice within one week after birth and 80% of preterm infants show jaundice within 24 hours after birth.
The normal values for neonatal jaundice are based on serum bilirubin levels as the reference indicator. For full-term infants, the level should not exceed 204 μmol/L (12 mg/dl), and for premature infants, it should not exceed 255 μmol/L (15 mg/dl).
What is the normal value for jaundice in premature infants? In medicine, jaundice in babies under one month old (born within 28 days) is referred to as neonatal jaundice. The main symptoms include yellowing of the skin, mucous membranes, and sclera. The baby may also exhibit symptoms such as poor appetite, restlessness, and increased body temperature.
Transient neonatal jaundice is a common condition in newborns, with 60% of full-term infants showing jaundice within one week after birth, and 80% of preterm infants exhibiting jaundice within 24 hours after birth.
Premature jaundice is primarily due to the incomplete development of the neonatal liver function and abnormal bilirubin metabolism, resulting in a rise in blood bilirubin concentration. It can be divided into physiological jaundice and pathological jaundice.
The normal range for jaundice in premature infants is determined based on serum bilirubin levels as a reference indicator. As long as the full-term infant's bilirubin level does not exceed 204 μmol/L (12 mg/dl), and the premature infant's level does not exceed 255 μmol/L (15 mg/dl), it is considered within the normal range.
In addition, the symptoms of physiological jaundice in children are not accompanied by significant changes in appetite or mental state, and usually resolve spontaneously within one month.
Children with pathological jaundice not only show changes in their skin but also cry, fuss, and refuse to feed. In such situations, parents must promptly take the child to a hospital for treatment, as delaying treatment could lead to kernicterus, which can have serious consequences.
Symptoms of premature infant jaundice, what are the symptoms of premature infant jaundice? Premature infant jaundice is a condition in which increased bilirubin in the body leads to jaundice in skin and sclera.
Premature infants are more prone to jaundice, with numerous and complex causes that can lead to bilirubin encephalopathy (kernicterus), often resulting in death or severe sequelae.
The specific symptoms of neonatal jaundice in preterm infants include: 1. The production of bilirubin is increased due to the premature birth, with the daily production of bilirubin being two times that of an adult. This is because the number of red blood cells in preterm infants at birth is relatively higher.
Its lifespan is shorter than that of adults, about 20 to 40 days, and it is destroyed quickly.
The source of bypass bilirubin is multifactorial, and the high content of heme oxygenase in blood during the first 7 days of life contributes to its potential for generating bilirubin.
2. The liver is immature, and the Y and Z proteins in the hepatocytes are low, with poor ability to take up bilirubin, reaching adult levels within 5 to 15 days.
In hepatocytes, the activity and quantity of UDPGT are deficient, leading to poor function in conjugating bilirubin.
3. The enterohepatic circulation is unique; premature infants, when newborn, lack the normal flora in their intestines and cannot convert the bilirubin entering the intestine into urine or feces.
Moreover, premature infants have higher uridine diphosphate glucoronidase activity in the intestines, which hydrolyzes bilirubin conjugates into glucuronide and unconjugated bilirubin. The latter is then absorbed by the intestinal wall and transported through the hepatic portal vein to the liver.
It has increased the burden on the liver.
The reasons for neonatal jaundice in preterm infants are higher than those in full-term infants and are more severe. Generally, there is a higher level of bilirubin and the jaundice is harder to fade. Parents can give their baby some sugar water, and it is necessary to go to the hospital for examination and treatment.
What causes jaundice in preterm infants? 1. Preterm infants generally have higher levels of bilirubin (possibly related to the immature development of the liver).
2. Premature infants have a more prolonged jaundice, often persisting for more than ten days before subsiding.
3. The causes of preterm delivery are often also the causes of neonatal jaundice (such as congenital infection).
4. Premature infants often experience complications such as neonatal asphyxia, septicemia, respiratory distress syndrome, and intracranial hemorrhage, which may exacerbate jaundice.
5. Premature infants are at a higher risk of developing kernicterus due to elevated bilirubin levels.
6. Correct hypoxia and disturbances in water and electrolyte balance, maintaining acid-base balance.
Premature infants are more likely to develop jaundice earlier and at a higher level, and the duration of the condition is longer. Therefore, parents should pay attention to monitoring and intervening with hyperbilirubinemia in premature infants who have persistently high serum bilirubin levels for an extended period.
What should be done about premature infant jaundice? What should be done about premature infant jaundice? In fact, most premature infant jaundice does not require treatment.
To prevent the occurrence of neonatal hemolytic jaundice, it is first necessary for pregnant women to actively cooperate with their doctor in completing systematic prenatal examinations, identify problems in a timely manner, and deal with them promptly.
Should pregnant women and their husbands have incompatible blood types, further testing of the antibodies in the pregnant woman's blood is necessary. If necessary, appropriate treatment should be administered to reduce the likelihood of neonatal hemolysis.
Additionally, it is crucial to provide perinatal care for newborns, conduct timely diagnosis and treatment, and initiate hematopoietic transfusion in the early stages of kernicterus to mitigate its risks.
Premature infants' jaundice can be classified into pathological or physiological. Physiological jaundice typically begins on the third day and lasts from 10 to 15 days, but in preterm infants, it may persist for up to a month.
If the child shows jaundice or jaundice develops too fast within 24 hours after birth, lasts for a long time and even accompanied by anemia, abnormal body temperature, poor feeding, vomiting, abnormal color of urine and stool.
Some cases of jaundice have subsided or reduced, only to reappear and worsen again, which is typically pathological.
Pathological jaundice, common causes include neonatal hemolysis, neonatal infections, congenital malformations of the biliary tract, and neonatal hepatitis.
Physiological jaundice can be alleviated by giving the baby some sugar water or making a decoction of pears. It is also beneficial to expose him to morning sunlight.
The doctor may order a baby to be exposed to blue light for pathological jaundice.
In the event of jaundice, parents should not panic; they should remain calm and handle the baby's condition rationally.
Is neonatal jaundice treated? Neonatal jaundice is a clinical manifestation caused by the accumulation of bilirubin in the body due to various reasons.
Can preterm infant jaundice be treated? What is the treatment? 1. Phototherapy.
Phototherapy is one of the effective and safe methods for treating neonatal jaundice, characterized by its effectiveness, ease of implementation, and minimal toxic side effects. It includes devices such as phototherapy cabinets, cold light blue-light beds, and blue-light blankets.
Phototherapy is only used for the treatment of hyperbilirubinemia.
It is suggested that phototherapy be given to extremely low birth weight infants at less than 30 weeks of gestation for prophylaxis.
2. Hemotransfusion therapy.
The blood exchange therapy can directly remove bilirubin, sensitized red blood cells, antibodies, and harmful substances from the blood.
Correcting anemia and preventing heart failure are among the most effective methods for reducing serum bilirubin concentration and preventing kernicterus.
The indication for exchange transfusion is a serum bilirubin level >342 μmol/L (20 mg/dL).
3. Pharmacological Treatment: (1) If there are high-risk factors for bilirubin encephalopathy, symptomatic treatment should be administered.
Enzyme inducer: Phenobarbital, 5-10 mg/kg/day, divided into 2-3 doses.
Nikethamide 0.1, three times daily.
(2) Administration of Albumin or Fresh Plasma: Albumin at a dose of 1g/kg/day, administered intravenously. 1g of albumin can bind 16g of bilirubin. Alternatively, plasma can be administered at 25-30ml once or twice daily.
(3) Corticosteroids: Corticosteroids can be used to suppress the hemolysis process. Prednisone 2.5 mg per dose, 2-3 times daily.
It can increase the binding ability of hepatocellular enzymes to bilirubin, preventing the reaction between antigen and antibody.
(4) Correcting Acidosis: Administration of 5% sodium bicarbonate at a rate of 3-5 ml/kg is beneficial for the binding of bilirubin and albumin.
Traditional Chinese Medicine Treatment: The modified Yinchenhao Tang can be used.
(6) Intravenous drip of glucose.
The medical information provided in this article is for reference only.
In case of discomfort, it is recommended to seek medical attention immediately. The diagnosis and treatment are subject to professional medical consultations in person.