Background: Hyperbilirubinemia is a benign transitional phenomenon that occurs in
60% to 80% of all term infants. The degree of hyperbilirubinemia and hence risk for developing
bilirubin-induced neurologic dysfunction or BIND is dependent upon two major processes: (i) bilirubin
production and its elimination.
Objective: The aim of this review is to address the importance of hemolysis and its clinical detection
in neonates with hyperbilirubinemia.
Results: In newborns, an increased bilirubin production rate due to hemolysis is often the primary
cause of hyperbilirubinemia during the first week of life. If undiagnosed or untreated, it may lead to
an increased risk for BIND. Therefore, the ability to identify infants with hemolytic disease is important
in assessing those at risk for developing BIND. In addition, an infant’s genetic profile and
bilirubin binding status can also affect their overall capacity to cope with the resultant tissue bilirubin
load and affect risk and guide appropriate management strategies.
Conclusion: Therefore, the determination of a newborn’s bilirubin production rate is critical to the
assessment of a newborn’s risk for developing unpredictable extreme hyperbilirubinemia and preventing