Epidemiology

In the US, about 60% to 70% of healthy newborns develop hyperbilirubinemia in the first week of life.[2] Severe hyperbilirubinemia (total serum bilirubin >95th percentile) occurs in 8% to 9% of neonates during the first week; approximately 4% after 72 hours of life.[3] Incidence data for low and middle income countries vary.[4] The incidence of East Asians in a US Washington state population-based study was higher than that of white infants.[5] The risk for neonatal hyperbilirubinemia is higher in males and increases progressively with decreasing gestational age. In a predominantly white and breast-fed population in Michigan, the 95th percentile total serum bilirubin level at 96 hours of life was 13.1 mg/dL.[6] In studies from Pennsylvania and Northern California, the 95th percentile was 17.5 mg/dL.[1]​​[7]​​​​​​​ In a mixed population of neonates from the US, Hong Kong, Japan, and Israel, the 95th percentile was 15.5 mg/dL.[8]

Global trends/differences: term, healthy formula-fed neonates have peak total serum bilirubin levels 5-6 mg/dL, with Japanese neonates having levels twice that.[8]

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