Causas fisiológicas y maternas para la aparición de la ictericia neonatal. Revisión sistemática

Lisbeht Anahi Quishpe-Curicho; Eulalia Isabel Analuisa-Jimenez

Authors

Quishpe-Curicho Lisbeht Anahi Universidad Técnica de Ambato. Ambato, Ecuador. https://orcid.org/0000-0003-1704-4563
Analuisa-Jimenez Eulalia Isabel Universidad Técnica de Ambato. Ambato, Ecuador. https://orcid.org/0000-0002-7906-7640

Keywords:

Jaundice, Neonatal; Hyperbilirubinemia; Recién Nacido; Blood Group Incompatibility; Kernicterus

Abstract

DOI: https://doi.org/10.46296/gt.v8i16.0297

Abstract

Neonatal jaundice is a common clinical manifestation affecting between 60% and 80% of full-term newborns and more than 80% of preterm infants, causing approximately 114000 deaths annually and more than 63000 cases of preventable neurological disability worldwide. This condition results from intrinsic physiological mechanisms of the newborn and maternal factors that increase the risk of hyperbilirubinemia. The overall objective was to analyze the physiological and maternal causes of neonatal jaundice. A systematic review was conducted following PRISMA guidelines, including articles published between 2020 and 2025 in Spanish, English, and Portuguese. The search was conducted in PubMed, Scopus, and SciELO, initially identifying 353 records. After applying eligibility criteria, 20 articles addressing physiological and maternal causes of neonatal hyperbilirubinemia were selected. The results showed that the main physiological causes include immaturity of the hepatic conjugation system with reduced UGT1A1 enzyme activity, shortened erythrocyte lifespan, glucose-6-phosphate dehydrogenase deficiency, prematurity, low birth weight, and increased enterohepatic circulation. The most significant maternal factors were ABO incompatibility (present in 30.7% to 50% of cases), advanced maternal age over 35 years, cesarean delivery, gestational diabetes, hypertensive disorders, perinatal infections, and problems related to inadequate breastfeeding. The synergistic interaction between physiological and maternal causes exponentially increases the severity of hyperbilirubinemia, increasing the risk of serious neurological complications. It is concluded that early identification of physiological and maternal risk factors allows for the implementation of effective preventive strategies, reducing associated neonatal morbidity and mortality. Prenatal maternal education, close monitoring of high-risk newborns, and standardized screening protocols are essential to prevent severe cases of kernicterus.

Keywords: Jaundice, Neonatal; Hyperbilirubinemia; Recién Nacido; Blood Group Incompatibility; Kernicterus.

Downloads

Download data is not yet available.

References

Ayalew, T., Molla, A., Kefale, B., Alene, T. D., Abebe, G. K., Ngusie, H. S., & Zemariam, A. B. (2024). Factors associated with neonatal jaundice among neonates admitted at referral hospitals in northeast Ethiopia: A facility-based unmatched case-control study. BMC Pregnancy and Childbirth, 24(1), 150. https://doi.org/10.1186/s12884-024-06352-y

Bahr, T. M., Christensen, R. D., & Kaplan, M. (2021). Hemolytic causes of neonatal jaundice: Diagnosis and treatment. Pediatric Medicine (Hong Kong, China), 4, 32–32. https://doi.org/10.21037/pm-21-14

Bhutani, V. K., Zipursky, A., Blencowe, H., Khanna, R., Sgro, M., Ebbesen, F., Bell, J., Mori, R., Slusher, T. M., Fahmy, N., Paul, V. K., Du, L., Okolo, A. A., de Almeida, M.-F., Olusanya, B. O., Kumar, P., Cousens, S., & Lawn, J. E. (2019). Neonatal hyperbilirubinemia and Rhesus disease of the newborn: Incidence and impairment estimates for 2010 at regional and global levels. Pediatric Research, 74(Suppl 1), 86–100. https://doi.org/10.1038/pr.2013.208

Bratton, S., Cantu, R. M., & Stern, M. (2023). Breast milk jaundice. NIH.gov. https://www.ncbi.nlm.nih.gov/books/NBK537334/

Caicedo Gallardo, D. A., Corella Sanguil, P. H., Miranda Cevallos, M. S., & Chávez Rosario, K. M. (2020). Factores de riesgo asociados a hiperbilirrubinemia neonatal. RECIAMUC, 4(3), 216–226. https://doi.org/10.26820/reciamuc/4.(3).julio.2020.216-226

Choi, Y., Park, S., & Lee, H. (2025). Neonatal jaundice requiring phototherapy risk factors in a newborn nursery: Machine learning approach. Children (Basel, Switzerland), 12(8), 1020. https://doi.org/10.3390/children12081020

Córdova-Cairampoma, L. (2024). Factores asociados con la ictericia neonatal en un hospital regional a gran altitud: Un estudio transversal. Investigación e Innovación Clínica y Quirúrgica Pediátrica, 2(2). https://doi.org/10.59594/iicqp.2024.v2n2.99

Diala, U. M., Usman, F., Appiah, D., Hassan, L., Ogundele, T., Abdullahi, F., Satrom, K. M., Bakker, C. J., Lee, B. W., & Slusher, T. M. (2023). Global prevalence of severe neonatal jaundice among hospital admissions: A systematic review and meta-analysis. Journal of Clinical Medicine, 12(11). https://doi.org/10.3390/jcm12113738

Díaz Romero, A., Querol Espallargas, R., Calvo Coscojuela, M., Urbón Primicia, E., Antón Fernández, A., & Martínez Villar, L. (2024). Cuidados de enfermería en el tratamiento de la ictericia neonatal: Revisión bibliográfica. Revista Sanitaria de Investigación, 5(6), 258. https://dialnet.unirioja.es/servlet/articulo?codigo=9693513

Espinoza Díaz, C. I., Morales Carrasco, A. P., Shiguango Shiguango, N. N., Méndez Cordero, P. D., Córdova Córdova, H. S., Toscano Núñez, A. H., Sánchez Centeno, E. I., Chancusig Chisag, M. A., Bastidas Toapanta, N. E., Vaca Rivadeneyra, E. C., Gómez Félix, G. P., & Tapia Caisaguano, A. D. (2019). Incidencia y características clínicas de neonatos con hiperbilirrubinemia del Hospital General José María Velasco Ibarra, Ecuador. Archivos Venezolanos de Farmacología y Terapéutica. https://reunir.unir.net/handle/123456789/9477

Hansen, T. W. R. (2021). Narrative review of the epidemiology of neonatal jaundice. Pediatric Medicine (Hong Kong, China), 4, 18–18. https://doi.org/10.21037/pm-21-4

Hernández Zambrano, Y. C., Palacios Paredes, E. G., & Rodríguez Plasencia, A. (2021). Atención al recién nacido que requiere exanguinotransfusión. Revista Universidad y Sociedad, 13(6), 566–571. http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S2218-36202021000600566

Huang, Y., Chen, L., Wang, X., Zhao, C., Guo, Z., Li, J., Yang, F., & Cai, W. (2022). Maternal knowledge, attitudes and practices related to neonatal jaundice and associated factors in Shenzhen, China: A facility-based cross-sectional study. BMJ Open, 12(8), e057981. https://doi.org/10.1136/bmjopen-2021-057981

Isa, H. M., AlBuainain, N. Y., Bunajem, F. Y., Masood, A. S., & Bucheery, Y. A. (2022). Neonatal and maternal risk factors for indirect hyperbilirubinemia: A cross-sectional study from Bahrain. International Journal of Pediatrics, 2022, 5199423. https://doi.org/10.1155/2022/5199423

Jiang, N., Qian, L., Lin, G., Zhang, Y., Hong, S., Sun, B., Wang, H., Huang, M., Wang, J., & Jiang, Q. (2023). Maternal blood parameters and risk of neonatal pathological jaundice: A retrospective study. Scientific Reports, 13(1), 2627. https://doi.org/10.1038/s41598-023-28254-3

Lin, Q., Zhu, D., Chen, C., Feng, Y., Shen, F., & Wu, Z. (2022). Risk factors for neonatal hyperbilirubinemia: A systematic review and meta-analysis. Translational Pediatrics, 11(6), 1001–1009. https://doi.org/10.21037/tp-22-229

Macero Méndez, R. M., Piedra Sigcha, J. M., & Plaza Chacha, G. M. (2023). Prevalencia y factores asociados a la ictericia neonatal. Revista de la Facultad de Ciencias Médicas de la Universidad de Cuenca, 41(2). https://doi.org/10.18537/rfcm.41.02.05

Olusanya, B. O., Kaplan, M., & Hansen, T. W. R. (2018). Neonatal hyperbilirubinaemia: A global perspective. The Lancet Child & Adolescent Health, 2(8), 610–620. https://doi.org/10.1016/S2352-4642(18)30139-1

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., et al. (2021). Declaración PRISMA 2020: Una guía actualizada para la publicación de revisiones sistemáticas. Revista Española de Cardiología, 74(9), 790–799. http://dx.doi.org/10.1016/j.recesp.2021.06.016

Parastatidou, S., Tsantes, A. G., Emmanouil, C.-C., Konstantinidi, A., Kapetanaki, A., & Sokou, R. (2025). Neonatal hemolytic jaundice: Causes, diagnostic approach, and management. Children (Basel, Switzerland), 12(6), 666. https://doi.org/10.3390/children12060666

Pettersson, M., Ryen, L., Eriksson, M., & Ohlin, A. (2023). The cost-effectiveness of home phototherapy for hyperbilirubinemia in neonates: Results from a randomized controlled trial. Scientific Reports, 13(1), 10727. https://doi.org/10.1038/s41598-023-37684-y

Rodrigues Bezerra, L. M., Silva de Brito, M. C., Melo de Assis Dias, R. C., Brito Bacelar Viana Andrade, C. de J., Guimarães Fernandes, L. F. A., Batista da Costa, E. S., Leal Neto, R. L., Pereira Sardinha, V. C., & Peres Costa, T. (2024). Bases fisiopatológicas da icterícia neonatal: Uma revisión bibliográfica. RECIMA21 - Revista Científica Multidisciplinar, 5(3), e535012. https://doi.org/10.47820/recima21.v5i3.5012

Salazar Porras, D., Aguilar Hernández, L. M., & González Alfaro, F. J. (2023). Ictericia neonatal: Manifestación clínica frecuente en pediatría. Revista Médica Sinergia, 8(8), e1085. https://doi.org/10.31434/rms.v8i8.1085

Sánchez Aldaz, K. G., Guarate Coronado, Y. C., Tipán Coello, Y. E., Panchi Rocha, D. M., & Villavicencio Guerrero, D. P. (2024). Intervención educativa para madres de neonatos en el reconocimiento temprano de hiperbilirrubinemia patológica. https://doi.org/10.5281/ZENODO.13119888

Santana Toala, F., Soriano Del Pezo, M., Toala Lucas, C., & Piguave Reyes, J. (2023). Causas y efectos de hiperbilirrubinemia en neonatales. Revista Científica Arbitrada Multidisciplinaria PENTACIENCIAS, 5(3), 643–658. https://doi.org/10.59169/pentaciencias.v5i3.592

Sarmiento Orellana, N. P., & Ortiz Tejador, J. G. (2024). Caracterización de la ictericia neonatal y factores asociados a recién nacidos. Ciencia Latina Revista Científica Multidisciplinar, 8(4), 1198–1214. https://doi.org/10.37811/cl_rcm.v8i4.12351

Siroosbakht, S., Aminian, A. R., & Rezakhaniha, B. (2020). Risk factors of early breastfeeding jaundice: How can gynecologists and nurses be effective in reducing it? Journal of Comprehensive Pediatrics, 11(3). https://doi.org/10.5812/compreped.103578

Sisay, B. D., Abebe, R. F., Kassie, A. A., Wondimu, M. G., & Kassie, G. A. (2023). Determinants of neonatal jaundice among neonates admitted to neonatal intensive care unit in public hospitals of Sidama Region, Sidama, Ethiopia, 2022: An unmatched case-control study. The Pan African Medical Journal, 45, 117. https://doi.org/10.11604/pamj.2023.45.117.40472

Solano Maza, L. O., Nuñez Quezada, T. del C., Cambizaca Flores, M. Y., & Reyes Solórzano, J. K. (2024). Ictericia neonatal por incompatibilidad sanguínea materno–fetal en el Hospital Gineco Obstétrico Ángela Loayza de Ollagüe, 2021–2023. LATAM Revista Latinoamericana de Ciencias Sociales y Humanidades, 5(4). https://doi.org/10.56712/latam.v5i4.2388

Taipe-Paucar, A., Toaquiza-Alvarado, A., & Merchán-Coronel, G. (2022). Ictericia neonatal a nivel de América Latina. FACSALUD-UNEMI, 6(10), 76–84. https://doi.org/10.29076/issn.2602-8360vol6iss10.2022pp76-84p

Toapanta-Pinta, P., Oliva-Velasco, V., Gavilanes-Vallejo, B., Caicedo-Gallardo, D., & Morales, S. V. (2024). From thesis to scientific articles: Publication of neonatal research in Ecuador. Revista de Gestão Social e Ambiental, 18(10), e09224. https://doi.org/10.24857/rgsa.v18n10-185

Vásquez-Hoyos, P., Romero, H., Álzate, J. P., Riaño, L. H., Góngora, M. M., & Roa, R. A. (2020). Factores de riesgo asociados a exanguinotransfusión por ictericia neonatal en un hospital universitario: Estudio de casos y controles. Revista Mexicana de Pediatría, 87(3), 91–96. https://doi.org/10.35366/94838

Warsame, H. A., Theuri, C., Abdullahi, N. M., Ahmed Keynan, A. M., & Ahmed, M. A. M. (2025). Prevalence and risk factors for neonatal jaundice: A multicentre analytical cross-sectional study at neonatal intensive care units, Mogadishu, Somalia. BMJ Open, 15(3), e096692. https://doi.org/10.1136/bmjopen-2024-096692

Yu, Y., Choi, J., Lee, M. H., Kim, K., Ryu, H. M., & Han, H. W. (2022). Maternal disease factors associated with neonatal jaundice: A case-control study. BMC Pregnancy and Childbirth, 22(1), 247. https://doi.org/10.1186/s12884-022-04566-6

PHYSIOLOGICAL AND MATERNAL CAUSES OF NEONATAL JAUNDICE. SYSTEMATIC REVIEW

Authors

Keywords:

Abstract

Downloads

References

Published

How to Cite

Issue

Section

Make a Submission