In the US, about 60% to 70% of healthy newborns develop hyperbilirubinemia in the first week of life.[2]Wong RJ, Stevenson DK. Neonatal hemolysis and risk of bilirubin-induced neurologic dysfunction. Semin Fetal Neonatal Med. 2015 Feb;20(1):26-30.
http://www.ncbi.nlm.nih.gov/pubmed/25560401?tool=bestpractice.com
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]Smitherman H, Stark AR, Bhutani VK. Early recognition of neonatal hyperbilirubinemia and its emergent management. Semin Fetal Neonatal Med. 2006 Jun;11(3):214-24.
http://www.ncbi.nlm.nih.gov/pubmed/16603425?tool=bestpractice.com
Incidence data for low and middle income countries vary.[4]Greco C, Arnolda G, Boo NY, et al. Neonatal Jaundice in Low- and Middle-Income Countries: Lessons and Future Directions from the 2015 Don Ostrow Trieste Yellow Retreat. Neonatology. 2016;110(3):172-80.
https://www.doi.org/10.1159/000445708
http://www.ncbi.nlm.nih.gov/pubmed/27172942?tool=bestpractice.com
The incidence of East Asians in a US Washington state population-based study was higher than that of white infants.[5]Setia S, Villaveces A, Dhillon P, et al. Neonatal jaundice in Asian, white, and mixed-race infants. Arch Pediatr Adolesc Med. 2002 Mar;156(3):276-9.
https://www.doi.org/10.1001/archpedi.156.3.276
http://www.ncbi.nlm.nih.gov/pubmed/11876673?tool=bestpractice.com
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]Maisels MJ, Kring E. Transcutaneous bilirubin levels in the first 96 hours in a normal newborn population of > or = 35 weeks' gestation. Pediatrics. 2006 Apr;117(4):1169-73.
http://www.ncbi.nlm.nih.gov/pubmed/16585312?tool=bestpractice.com
In studies from Pennsylvania and Northern California, the 95th percentile was 17.5 mg/dL.[1]Bhutani VK, Johnson L, Sivieri EM. Predictive ability of a predischarge hour-specific serum bilirubin for subsequent significant hyperbilirubinemia in healthy term and near-term newborns. Pediatrics. 1999 Jan;103(1):6-14.
http://www.ncbi.nlm.nih.gov/pubmed/9917432?tool=bestpractice.com
[7]Kemper AR, Newman TB, Slaughter JL, et al. Clinical practice guideline revision: management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2022 Sep 1;150(3):e2022058859.
https://publications.aap.org/pediatrics/article/150/3/e2022058859/188726/Clinical-Practice-Guideline-Revision-Management-of
In a mixed population of neonates from the US, Hong Kong, Japan, and Israel, the 95th percentile was 15.5 mg/dL.[8]Maisels MJ. What's in a name? Physiologic and pathologic jaundice: the conundrum of defining normal bilirubin levels in the newborn. Pediatrics. 2006 Aug;118(2):805-7.
http://www.ncbi.nlm.nih.gov/pubmed/16882840?tool=bestpractice.com
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]Maisels MJ. What's in a name? Physiologic and pathologic jaundice: the conundrum of defining normal bilirubin levels in the newborn. Pediatrics. 2006 Aug;118(2):805-7.
http://www.ncbi.nlm.nih.gov/pubmed/16882840?tool=bestpractice.com