Newborn Hyperbilirubinemia Assessment
Estimate risk zone for neonatal jaundice based on age in hours, total serum bilirubin (TSB), and clinical risk factors.
Risk Assessment
Bhutani zone
High-intermediate risk
Recommendation
Intermediate-high risk: Consider phototherapy, repeat bilirubin in 4–6 hours, and evaluate risk factors closely.
Reference thresholds at 48 hours:
- High risk line: ≥ 13.0 mg/dL
- High-intermediate: 10.0 – 13.0 mg/dL
- Low-intermediate: 7.0 – 10.0 mg/dL
- Low risk: < 7.0 mg/dL
How to Use This Calculator
Measure bilirubin accurately
Prefer TSB lab values; transcutaneous bilirubin should be confirmed if elevated.
Use exact age in hours
Risk thresholds change quickly in the first days; calculate hours since birth precisely.
Consider risk factors
Hemolysis, prematurity, sepsis, and G6PD deficiency lower treatment thresholds.
Formula
This calculator interpolates the Bhutani nomogram risk lines:
Data derived from Bhutani VK et al., Pediatrics 1999, and 2022 American Academy of Pediatrics guidelines for management of hyperbilirubinemia.
Frequently Asked Questions
Does this replace the 2022 AAP calculator?
No. Use it for initial triage, then consult the official AAP treatment nomograms for final management.
How often should bilirubin be rechecked?
Depends on zone: 4–6 hours for high risk, 12–24 hours for intermediate, per guideline.
Can TcB be used?
Yes for screening. Confirm with serum if TcB ≥15 mg/dL or near phototherapy thresholds.
What if the baby is very premature?
Use NICU-specific charts (e.g., Maisels) as thresholds differ significantly.
Does ABO incompatibility count as isoimmune disease?
Yes, especially with a positive direct Coombs test and hemolysis.