Physical Findings in Neonatal Jaundice
Findings | Timing of Jaundice | Potential Cause |
|---|---|---|
General examination | ||
Fever, tachycardia, respiratory distress | First 24 hours Accumulates > 5 mg/dL/day (> 86 micromol/L/day) | |
Lethargy, hypotonia | May appear in the first 24–48 hours Can be prolonged (> 2 weeks) | Hypothyroidism, metabolic disorder |
Macrosomia | 24–48 hours Can accumulate > 5 mg/dL (> 86 micromol/L) | |
Petechiae | First 24 hours Accumulates > 5 mg/dL (> 86 micromol/L) | Hemolytic states (eg, maternofetal blood group incompatibility, red blood cell enzyme deficiencies, hereditary spherocytosis, thalassemias, sepsis) |
Plethora | First 24 hours Accumulates > 5 mg/dL (> 86 micromol/L) | Maternofetal or fetofetal transfusion, delayed umbilical cord clamping |
Head and neck examination | ||
Bilateral slanting palpebral fissures, flat nasal bridge, macroglossia, flattened occiput | First 2–3 days | |
Cephalohematoma | 24–48 hours Can accumulate > 5 mg/dL (> 86 micromol/L) | |
Macroglossia | 24–48 hours Can be prolonged (> 2 weeks) | |
Abdominal examination | ||
Abdominal distention, decreased bowel sounds | Possible delayed manifestation (2–3 days or later) | Intestinal obstruction (eg, cystic fibrosis, Hirschsprung disease, intestinal atresia or stenosis, pyloric stenosis, biliary atresia) |
TORCH = toxoplasmosis, other pathogens, rubella, cytomegalovirus, and herpes simplex. | ||