Preface

This book provides an update on topics related to Update on Critical Issues on Infant and Neonatal Care. Based on the experience and knowledge of professionals from around the world, the book presents an updated review of fundamental topics related to cardiorespiratory, metabolic, infectious, and development disorders.

The book includes six chapters. The first chapter presents the analyzed experience from the Republic of North Macedonia on one of the most frequent newborn problems, neonatal hyperbilirubinemia.

Chapters 2 and 3 focus on two respiratory disorders often faced by the health team caring for newborns and infants: neonatal respiratory distress syndrome and bronchiolitis, respectively.

Chapter 4 aims to clarify different aspects of the closure of the patent ductus arteriosus, emphasizing the moment of and the alternatives for closure.

The last two chapters include a description of two screening tools. Chapter 5 discusses screening for a common infectious problem in neonatal units (congenital CMV infection), while Chapter 6 describes the Mexican experience of a neurobehavioral infant development disorder screening tool.

As described, this book includes various topics of interest for health professionals who are dedicated to neonatal and infant health care. I thank all the authors, who through their contributions taken from both experience and context, have allowed for the development of this interesting book that is expected to be useful for professionals and students dedicated to neonatal and infant care.

> **R. Mauricio Barría P., DrPH** Faculty of Medicine, Institute of Nursing, Universidad Austral de Chile, Valdivia, Chile

**1**

**Chapter 1**

**Abstract**

Neonatal Hyperbilirubinemia

*Natasha Najdanovska Aluloska, Nikolina Zdraveska,* 

Neonatal indirect hyperbilirubinemia is one of the most frequent neonatal problems that affect almost two thirds of term infants. Although etiology of jaundice has been widely studied, identification of pathological causes presents constant clinical challenge. Our study group performed an extensive retrospective study of etiology of neonatal hyperbilirubinemia and showed high frequency (44.37%) of jaundice of undefined etiology. The group included exaggerated physiological jaundice, earlyand late-onset breast-milk jaundice, and no identifiable etiology. Other etiologies were neonatal infection, prematurity, birth trauma, and hemolysis represented with 15%. We described hematological parameters in both non-hemolytic and hemolytic type of jaundice; a significant correlation of relevant laboratory findings with etiology was established. In this chapter we will present our own data and perform a data-relevant literature review. Furthermore, investigation and management plan of neonatal indirect hyperbilirubinemia will be presented in accordance

**Keywords:** neonatal indirect hyperbilirubinemia, etiology, undefined jaundice,

Neonatal hyperbilirubinemia is defined as a total serum bilirubin level >5 mg/dL (86 μmol/L). This is a frequently encountered problem during the first week of life that affects approximately 60% of term and 80% of preterm babies [1, 2]. About 10% of breastfed babies are still jaundiced at 1 month of age [1]. The yellowish coloration results from deposition of unconjugated bilirubin pigment into the skin and mucous membranes [2]. Generally, neonatal jaundice is considered a transitional phenomenon without noticeable clinical impact, related to hepatic, red cell, and gastrointestinal immaturity [1, 3]. However, hyperbilirubinemia in the newborn period can be associated with severe illnesses such as hemolytic disease, metabolic and endocrine disorders, anatomic abnormalities of the liver, and infections [2]. Acute bilirubinassociated neuropathy caused by a dangerous rise of the total serum bilirubin level can often progress into a chronic neurologic condition characterized as kernicterus.

North Macedonia

with own data and available literature.

hemolysis, hematological parameters

**1. Introduction**

*Anet Papazovska Cherepnalkovski,* 

*Katica Piperkova and Vjekoslav Krzelj*

in Newborns of the Republic of
