Fatores associados e causas de icterícia neonatal em bebês a termo com necessidade de fototerapia

Daniela Hespanha Marinho; Bruna Mai dos Santos; Maria Luiza Souza Nieto; Regina Paula Guimarães Vieira Cavalcante da Silva; Paulyne Stadler Venzon; Patricia Povaluk; Fabiano Steil da Silva; Carlos Alberto Fernandes Baltar

doi:10.36489/saudecoletiva.2026v17i109p20256-20273

Authors

Daniela Hespanha Marinho Médica Pediatra e Neonatologista - Docente com doutorado - Departamento de Pediatria – UFPR - Complexo Hospital de Clínicas – Universidade Federal do Paraná; Curitiba - PR https://orcid.org/0000-0002-9699-7241
Bruna Mai dos Santos Residência em Pediatria – Complexo Hospital de Clínicas - Universidade Federal do Paraná, Curitiba - PR https://orcid.org/0009-0006-9921-2813
Maria Luiza Souza Nieto Residência em Pediatria – Complexo Hospital de Clínicas – Universidade Federal do Paraná https://orcid.org/0000-0002-6210-9584
Regina Paula Guimarães Vieira Cavalcante da Silva Médica Pediatra e Neonatologista - Docente com doutorado – Departamento de Pediatria - Complexo Hospital de Clínicas – Universidade Federal do Paraná, Curitiba - PR https://orcid.org/0000-0002-2467-1760
Paulyne Stadler Venzon Médica Pediatra e Neonatologista - Docente com doutorado – Departamento de Pediatria – Complexo Hospital de Clínicas – Universidade Federal do Paraná, Curitiba - PR https://orcid.org/0000-0002-2976-5205
Patricia Povaluk Médica Pediatra e Neonatalogista com mestrado – Complexo Hospital de Clínicas - Universidade Federal do Paraná, Curitiba - PR https://orcid.org/0000-0001-5086-5270
Fabiano Steil da Silva Médico Pediatra e Neonatologista - Docente com mestrado – Departamento de Pediatria - Complexo Hospital de Clínicas – Universidade Federal do Paraná https://orcid.org/0000-0003-1306-2182
Carlos Alberto Fernandes Baltar Médico Pediatra e Neonatologista - Docente com mestrado – Departamento de Pediatria - Complexo Hospital de Clínicas – Universidade Federal do Paraná, Curitiba - PR https://orcid.org/0000-0002-7099-7008

DOI:

https://doi.org/10.36489/saudecoletiva.2026v17i109p20256-20273

Keywords:

Jaundice; Hyperbilirubinemia; Newborn.

Abstract

Objective: To Evaluate associated factors and causes of neonatal jaundice requiring phototherapy in term neonates. Method: Observational and prospective cross-sectional study included 187 term infants that developed neonatal jaundice and required phototherapy. Variables were presented as percentages, mean or median. P value <0.05 was considered statistically significant. Results: The most common associated factors found were delayed umbilical cord clamping (59.9%) and maternal age >25 years (57.2%). The most frequent causes were ABO incompatibility (40.1%) and breastfeeding jaundice (31.6%). In nonhemolytic disease, maternal age >25 years was found as a associated factor (p<0.001). Conclusion: Early identification of associated factors and causes of jaundice is important for the effective management of these newborns, aiming to reduce the length of stay and chance of sequelae.

References

Pasha YZ, Alizadeh-Tabari S, Pasha EZ, Zamani M. Etiology and therapeutic management of neonatal jaundice in Iran: a systematic review and meta-analysis. World J Pediatr. 2020;16(5):480-93. DOI: https://doi.org/10.1007/s12519-020-00339-3

Isa HM, AlBuainain NY, Bunajem FY, Masood AS, Bucheery YA. Neonatal and Maternal Risk Factors for Indirect Hyperbilirubinemia: A Cross-Sectional Study from Bahrain. Int J Pediatr. 2022;2022:5199423. DOI: https://doi.org/10.1155/2022/5199423

Tavakolizadeh R, Izadi A, Seirafi G, Khedmat L, Mojtahedi SY. Maternal risk factors for neonatal jaundice: a hospital-based cross-sectional study in Tehran. Eur J Transl Myol. 2018;28(3):257-64. DOI: https://doi.org/10.4081/ejtm.2018.7618

Zhang M, Tang J, He Y, Li W, Chen Z, Xiong T, Qu Y, Li y, et al. Systematic review of global clinical practice guidelines for neonatal hyperbilirubinemia. BMJ Open. 2021; 11(1):e040182. DOI: https://doi.org/10.1136/bmjopen-2020-040182

Olusanya BO,Kaplan M, Hansen TW. Neonatal hyperbilirubinaemia: a global perspective. Lancet Child Adolesc Health. 2018;2(8):610-20. DOI: https://doi.org/10.1016/S2352-4642(18)30139-1

Departamento Científico de Neonatologia da Sociedade Brasileira de Pediatria. Hiperbilirrubinemia indireta no período neonatal [Internet]. 2021 Sept [acesso em 2025 Sept 15]. Disponível em: https://www.sbp.com.br/fileadmin/user_upload/23176c-MO_Hiperbilirrubinemia_indireta_periodo_neo.pdf

Ayalew T, Molla A, Kefale B, Alene TD, Abebe GK, Ngusie HS, Zemariam AB. Factors associated with neonatal jaundice among neonates admitted at referral hospitals in northeast Ethiopia: a facility-based unmatched case-control study. BMC Pregnancy Childbirth. 2024;24(1):150. DOI: https://doi.org/10.1186/s12884-024-06352-y

Brits, H, Adendorff J, Huisamen D, Beukes D, Botha K, Herbst H, Ioubert G. The prevalence of neonatal jaundice and risk factors in healthy term neonates at National Disctrict Hospital in Bloemfontein. Afr J Prim Health Care Fam Med. 2018;10(1):e1-6. DOI: https://doi.org/10.4102/phcfm.v10i1.1582

Tsujimae S, Yoshi K, Yamana K, Fujioka K, Iijima K, Morioka I. Hyperbilirubinemia in Term Newborns Needing Phototherapy within 48 Hours after Birth in a Japanese Birth Center. Kobe J Med Sci. 2018;64(1):E20-25.

Kemper AR, Newman TB, Slaugther JL, Maisels MJ, Watchko JF, Downs SM, Grout RW, Bundy DG, et al. Clinical Practice Guideline Revision: Management of Hyperbilirubinemia in The Newborn Infant 35 or More Weeks of Gestation. Pediatrics. 2022;150(3):e2022058859. DOI: https://doi.org/10.1542/peds.2022-058859

ACOG Committee Opinion n°814. Delayed Umbilical Cord Clamping After Birth. Obstet Gynecol. 2020;136(6):e100-06. DOI: https://doi.org/10.1097/AOG.0000000000004167

Sociedade Brasileira de Pediatria (SBP); Federação Brasileira de Associações de Ginecologia e Obstetrícia (FEBRASGO). Recomendações sobre o clampeamento do cordão umbilical [Internet]. 2022 Mar [cited 2025 Sept 20]. Available from: https://www.sbp.com.br/imprensa/detalhe/nid/recomendacoes-sobre-o-clampeamento-do-cordao-umbilical/

Dias VSS, Pelicia SMC, Corrente JE, Rugolo LMSS. Icterícia neonatal: fatores associados à necessidade de fototerapia em alojamento conjunto. Resid Pediatr. 2022;12(3):459-64. DOI: https://doi.org/10.25060/residpediatr-2022.v12n3-459

Hudson JA, Charron E, Maple B, KromM, Heavner-Sullivan SF, Mayo RM, Dickes L, Rennert L. Baby-Friendly Hospital Initiative Is Associated with Lower Rates of Neonatal Hyperbiliribinemia. Breastfeed Med. 2020;15(3):176-82. DOI: https://doi.org/10.1089/bfm.2019.0220

American Academy of Pediatrics, Subcommittee on Hyperbilirrubinemia. Clinical Practice Guideline: Management of Hyperbilirubinemia in The NewBorn Infant 35 or More Weeks of Gestation. Pediatrics. 2004;114(1):297-316. DOI: https://doi.org/10.1542/peds.114.1.297

Yang WC, Zhao LL, Li YC, Chen CH, Chang YJ, Fu YC, Wu HP. Bodyweight loss in predicting neonatal hyperbilirubinemia 72 hours after birth in term newborn infants. BMC Pediatr. 2013;13:145-51. DOI: https://doi.org/10.1186/1471-2431-13-145

Norman M, Âberg K, Holmsten K, Weibel V, Ekéus C. Predicting Nonhemolytic Neonatal Hyperbilirubinemia. Pediatrics. 2015;136(6):1087-94. DOI: https://doi.org/10.1542/peds.2015-2001

van der Geest BAM, de Mol MJS, Barendse ISA, de Graaf JP, Bertens LCM, Poley MJ, Ista E, Kornelisse RF, et al. Assessment, management, and incidence of neonatal jaundice in healthy neonates cared for in a primary care: a prospective cohort study. Sci Rep. 2022;12(1):14385. DOI: https://doi.org/10.1038/s41598-022-17933-2

Lin Q, Zhu D, Chen C, Feng Y, Shen F, Wu Z. Risk factors for neonatal hyperbilirubinemia: a systematic review and meta-analysis. Transl Pediatr. 2022;11(6):1001-09. DOI: https://doi.org/10.21037/tp-22-229

Yasartekin Y, Sarici SU, Özcan M, Akpinar M, Altun D, Akin A, Serdar A, Sarici D. Investigation of the relationship between cord clamping time and risk of hyperbilirubinemia. Turk J Pediatr. 2020;62(5):756-62. DOI: https://doi.org/10.24953/turkjped.2020.05.006

Ofojebe CJ, Eleje GU, Ikechebelu JI, Okpala BC, Ofojebe BA, Ugwu EO, Igbodike EP, Onwuegbuna AA, et al. A randomized controlled clinical trial on peripartum effects of delayed versus immediate umbilical cord clamping on term newborns. Eur J Obstet Gynecol Reprod Biol. 2021;262:99-104. DOI: https://doi.org/10.1016/j.ejogrb.2021.04.038

Carvalho OMC, Augusto MCC, Medeiros MQ, Lima HMP, Viana Junior AB, Araujo Júnior E, Carvalho FHC. Late umbilical cord clamping does not increase rates of jaundice and need for phototherapy in pregnancies at normal risk. J Matern Fetal Neonatal Med. 2019;32(22):3824-29. DOI: https://doi.org/10.1080/14767058.2018.1473367

Olusanya BO, Slusher TM. Infants at risk of significant hyperbilirubinemia in poorly-resourced countries: evidence from a scoping review. World J Pediatr. 2015;11(4):293-99. DOI: https://doi.org/10.1007/s12519-015-0037-z

Miyoshi Y, Suenaga H, Aoki M, Tanaka S. Determinants of excessive weight loss in breastfed full-term newborns at a baby-friendly hospital: a retrospective cohort study. Int Breastfeed J.2020;15(1):19. DOI: https://doi.org/10.1186/s13006-020-00263-2

Lee BK, Ray IL, Sun JY, Wikman A, Reilly M, Johansson S. Haemolytic and nonhaemolytic neonatal jaundice have different risk factor profiles. Acta Paediatr. 2016;105(12):1444-50. DOI: https://doi.org/10.1111/apa.13470