Penyebab hiperbilirubinemia neonatus

MekanismePenyebab

Peningkatan sirkulasi enterohepatikBreast milk (breast milk jaundice)Breastfeeding failure (breastfeeding jaundice)Drug-induced paralytic ileus (Mg sulfate atau morfin)Puasa atau penyebab lain yang menyebabkan terjadinya hipoperistaltikHirschsprung's diseaseIntestinal atresia atau stenosis, termasuk annular pancreasMeconium ileus atau meconium plug syndromePyloric stenosis*

Darah yang tertelan

Overproduction

Pemecahan darah ekstravaskular ( Hematomas; petechiae; pulmonary, cerebral, or occult hemorrhage)

Polisitemia karena transfusi maternofetal atau fetofetal atau klem tali pusat terlambat

Overproduction karena anemia hemolitikObat-obatan atau beberapa agen tertentu pada neonatus dengan defisiensi G6PD ( Asetaminofen , alkohol, antimalarials, aspirin , bupivacaine, kortikosteroid, diazepam, nitrofurantoin , oksitosin , penisilin, phenothiazine, sulfonamid)Maternofetal blood group incompatibility (Rh, ABO)Defisiensi enzim eritrosit (G6PD atau piruvat kinase)SpherocytosisThalassemia (, )

Undersecretion karena obstruksi biliar1-Antitrypsin deficiency*Atresia biliar*Kista choledochal*Cystic fibrosis*Dubin-Johnson syndrome dan Rotor's syndrome* Nutrisi parenteralTumor or band* (extrinsic obstruction)

Undersecretion karena kondisi endokrin-metabolikCrigler-Najjar syndrome (familial nonhemolytic jaundice types 1 and 2)Obat-obatan dan hormonGilbert syndrome HypermethioninemiaHypopituitarism dan anencephalyHypothyroidismLucey-Driscoll syndromeMaternal diabetesPrematurityTyrosinosis

Gabungan overproduction dan undersecretionAsfiksiaInfeksi intrauterinMaternal diabetesRespiratory distress syndromeSepsisEritroblastosis fetalis beratSifilisInfeksi TORCH

*Jaundice juga dapat terjadi diluar usia neonatusTORCH = toxoplasmosis, other pathogens, rubella, cytomegalovirus, and herpes simplex.Adapted from Poland RL, Ostrea EM Jr: Neonatal hyperbilirubinemia. In Care of the High-Risk Neonate, ed. 3, edited by MH Klaus and AA Fanaroff. Philadelphia, WB Saunders Company, 1986.

G6PD, glucose-6-phosphate dehydrogenase; PK, pyruvate kinase. (From Oski FA: Differential diagnosis of jaundice. In Taeusch HW, Ballard RA, Avery MA [editors]: Schaffer and Avery's Diseases of the Newborn, 6th ed. PhiladG6PD, glucose-6-phosphate dehydrogenase; PK, pyruvate kinase. (From Oski FA: Differential diagnosis of jaundice. In Taeusch HW, Ballard RA, Avery MA [editors]: Schaffer and Avery's Diseases of the Newborn, 6th ed. Philadelphia, WB Saunders, 1991.) elphia, WB Saunders, 1991.)