Hiperbilirrubinemia neonatal y el papel del laboratorio clínico en el diagnóstico

Abstract

Introduction: Hyperbilirubinemia is the seventh leading cause of neonatal death; it affects about 60% of term newborns and 80% of premature infants. Objective: To evaluate the usefulness of currently available clinical laboratory tests for the diagnosis of neonatal hyperbilirubinemia and to summarize the most frequent risk factors in neonates for developing hyperbilirubinemia. Design: Systematic review. Materials and methods: Different investigations in the data bases of Elsevier, PubMed, Scopus, The Cochrane library were made and relevant article guides, published between 2018 and 2023 in the English language. The documents were examined with the PICO and PRISMA methodologies. Results: The systematic review evaluated 14 papers on the diagnosis and risk factors of neonatal hyperbilirubinemia. The 64.28% of documents established gestational age < 37 weeks as a risk factor, followed by family history in 57.14%, suboptimal feeding (neonatal malnutrition) in 50% and congenital anomalies in 42.85%. The 50% of documents established visual evaluation as a diagnostic test for neonatal hyperbilirubinemia, followed by total serum bilirubin in 85.71% and measurement of transcutaneous bilirubin in 64.28%. Conclusions: The exact quantification of total serum bilirubin by the clinical laboratory is considered the gold standard for the diagnosis, follow-up, and control of neonatal hyperbilirubinemia. Although transcutaneous bilirubin measurement and visual evaluation can also be used as diagnostic tests, it has been observed that the result of these tests is often inaccurate.