Calculator: Newborn hyperbilirubinemia assessment for infants born at ≥35 weeks gestation

Notes

Results are not available for newborn infants <12 hours old or >14 days old. This calculator should not be used for preterm neonates <35 weeks gestation.
* For newborns <96 hours old, enter the postnatal age in hours. For newborns ≥96 hours old, postnatal age can be entered in hours or days.
^¶ Clinical concern for bacterial or viral sepsis is based upon signs and symptoms and not solely on risk factors for sepsis (eg, maternal fever). Refer to separate UpToDate content on neonatal sepsis for additional details.
^Δ Alloimmune hemolytic disease may be suspected based upon maternal/infant blood type incompatibility and/or a positive DAT. A negative DAT does not exclude the diagnosis of alloimmune hemolytic disease, particularly in the setting of ABO incompatibility. Refer to separate UpToDate content on alloimmune hemolytic disease of the newborn for additional details.
The 2022 American Academy of Pediatrics (AAP) clinical practice guideline nomograms^[1] are used in determining when phototherapy or exchange transfusion should be initiated and when care should be escalated. When phototherapy is used, the AAP recommends using intensive phototherapy, defined as irradiance ≥30 microW/cm² per nm in the blue-green spectrum (wavelength between 430 and 490 nM).
The calculator results based on the AAP nomograms provide risk-based guidance for intervention for neonatal hyperbilirubinemia. They rely on the clinician’s judgment in addition to the bilirubin level and other factors listed above.
Calculated results can be confirmed using UpToDate graphics that show hour-specific phototherapy and exchange transfusion thresholds for newborns with and without neurotoxicity risk factors.
GA: gestational age; TcB: transcutaneous bilirubin level; G6PD: glucose-6-phosphate dehydrogenase; IV: intravenous; TSB: total serum or plasma bilirubin; DAT: direct antiglobulin test.

Total bilirubin level
Newborn’s postnatal age*
Gestational age (completed weeks)		wks
Significant clinical instability in the previous 24 hours?	Yes No
Clinical concern for sepsis?^¶	Yes No
Hemolytic condition (eg, isoimmune hemolytic disease, G6PD deficiency)?^Δ	Yes No Unknown
Hypoalbuminemia (albumin <3.0 g/dL)?	Yes No Unknown

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Calculator: Newborn hyperbilirubinemia assessment for infants born at ≥35 weeks gestation