Prevalence and Risk Factors of neonatal jaundice in low-birth-weight infants

Carlos Torres; L. Flores; I. Fernandez

doi:10.5281/zenodo.22814756

Authors

Carlos Torres Department of Neonatology, Volga Research Center for Neonatology Author https://orcid.org/0858-7066-0284-380X
L. Flores Department of Neonatology, Don Center for Pediatric Research Author https://orcid.org/5163-2312-2921-3164
I. Fernandez Department of Pediatric Research, Columbia Institute for Advanced Pediatric Research Author https://orcid.org/3818-4514-6250-0177

DOI:

https://doi.org/10.5281/zenodo.22814756

Keywords:

neonatal jaundice, low birth weight, hyperbilirubinemia, preterm infants, risk factors

Abstract

Graphical abstract

Background: Neonatal jaundice affects most low-birth-weight (LBW) infants, and immature hepatic conjugation, delayed feeding, and hemolysis push a disproportionate share toward thresholds for bilirubin-induced neurologic injury.

Objective: This review synthesizes evidence on the prevalence of neonatal jaundice among LBW and preterm infants and the risk factors most consistently linked to severe or prolonged hyperbilirubinemia.

Methods: We synthesized observational cohorts, hospital-based prevalence surveys, and systematic reviews addressing bilirubin kinetics, phototherapy thresholds, risk-factor stratification, and kernicterus outcomes in LBW and preterm neonates.

Findings: Reported prevalence of significant jaundice among LBW infants ranges from roughly 50% to over 80% across cohorts, with gestational age below 35 weeks, birth weight under 1500 g, ABO/Rh incompatibility, sepsis, inadequate feeding, and delayed meconium passage each independently associated with higher peak bilirubin and greater treatment need; low- and middle-income settings show disproportionately higher rates of severe hyperbilirubinemia and encephalopathy.

Conclusions: Low birth weight is among the strongest risk factors for both occurrence and severity of neonatal jaundice, and systematic risk stratification with earlier screening, feeding support, and timely phototherapy access could substantially reduce bilirubin-induced neurologic injury.

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