Neonatal hyperbilirubinemia and the role of the clinical laboratory in diagnosis

Abstract

Introduction. Hyperbilirubinemia is the seventh leading cause of neonatal death, it affects about 60% of term newborns and 80% of premature infants. The objective of this study is to evaluate the usefulness of currently available clinical laboratory tests for the diagnosis of neonatal hyperbilirubinemia and to summarize the most frequent risk factors in neonates for developing hyperbilirubinemia. Methodology. A systematic review of different investigations in the data bases of Elsevier, PubMed, The Cochrane Library, and relevant article guides, published between 2018 and 2023 in the English language were included. The documents were examined with the PRISMA methodology. Results. The systematic review evaluated 14 papers on the diagnosis and risk factors of neonatal hyperbilirubinemia. 64.28% of documents established a gestational age <37 weeks as a risk factor, followed by family history in 57.14%, suboptimal feeding (neonatal malnutrition) in 50%, and congenital anomalies in 42.85%. 50% of documents established visual evaluation as a useful method to determine the presence of neonatal hyperbilirubinemia, 85.71% recommend the measurement of total serum bilirubin as a diagnostic test, while transcutaneous bilirubin was recommended in 64.28%. Conclusion. The exact quantification of total serum bilirubin by the clinical laboratory is considered the gold standard for the diagnosis, follow-up, and control of neonatal hyperbilirubinemia. Although transcutaneous bilirubin measurement and visual evaluation can also be used to determine the presence of hyperbilirubinemia, it has been observed that the result of these tests is often inaccurate.