The Management of Neonatal Jaundice in Nigeria

Abstract

Jaundice is yellowish discolouration of the skin, sclera and mucous membranes.1 Neonatal jaundice (NNJ) is so common that it can be regarded as a normal physiologic adaptation of the newborn infant to extrauterine life. However, it may also be a symptom
or sign of an underlying disease. Neonatal jaundice is due to increased serum levels of bilirubin, a pigment derived mainly from the breakdown of haemoglobin. It becomes clinically visible when serum bilirubin level exceeds 5 mg/dL. Worldwide NNJ is an obsession of
neonatologists because of the association between raised unconjugated bilirubin levels and permanent neurological damage.2-6 Newborns produce bilirubin at a rate of 6-8 mg/kg/ day which is more than twice the production rate in adults.7,8 This is due to relatively large red cell mass, shorter red cell life span causing increased red cell turn-over in neonates.9 Bilirubin production in neonates however declines to adult level within 10 to 14 days after delivery.7 The prevalence of neonatal jaundice in clinical practice range between 23–60%.1 Jaundice is noticed during the first week of life in about 60% of term infants and 80% of preterm infants with only a few signifying underlying disease.

IFEMED Journal Vol. 14 (1) 2008: pp. 18-23