Neonatal Jaundice: When Do the Light Bulbs Go On? - Trinity Health

Neonatal Indirect-Unconjugated
Hyperbilirubinemia
• Enhanced production (2.5 times adult)-load:
– Shortened RBC life span
– Higher RBC Volume (higher hematocrit)
• Reduced hepatic cell entry (clearance) of bilirubin (ligandin)—
Uptake
• Reduced uridine diphosphate glucuronosyl transferase
(UDPGT) activity (1% of adult activity)—Conjugation
• Enhanced enterohepatic circulation—increased load
– Decreased oral intake-decreased intestinal motility
– High concentration of beta-glucuronidase activity (intestinal mucosa)resultant
hydrolysis of conjugated bilirubin and reabsorption of
unconjugated (indirect) bilirubin.
– Low amounts of bacteria