Difference between physiological and pathological jaundice

Indicators of pathological jaundice in newborn infants:

  • Early onset of clinical jaundice in the first 24 hours of age
  • Rapid rise of serum bilirubin at a rate faster than 5mg/dL/24 hr.
  • Sick newborn with jaundice
  • Serum bilirubin > 250μmol/l by 48h of age or > μ300 mol/l by 72h of age (serum bilirubin is >12 mg/dL in a full-term infant) (especially in the absence of risk factors) or 10-14 mg/dL in a preterm infant)
  • Failure to respond to phototherapy
  • Prolonged jaundice> 14 days in term infants and >21 days in preterm infants
  • Conjugated bilirubin level of >μ25 mol/l (>2 mg/dL at any time)
  • Pale chalky stools and dark urine.

The distinction between physiologic and pathologic jaundice relates to the timing, rate of rise, and extent of hyperbilirubinemia.