Risk Factors for Failing to Detect Kernicterus in Neonate

Gestational age at delivery

Was the infant noted to be jaundiced within 24 hours of delivery or before hospital delivery?

Was the serum bilirubin measured before the neonate was discharged from the hospital?

Was the neonate discharged at less than 48 hours after delivery?

Was there a followup within 48 hours of discharge?

Were steps taken to make sure that the infant had adequate hydration and nutrition?

Was the family instructed about signs and symptoms of significant hyperbili-rubinemia?

Were all of the pertinent risk factors for severe hyperbilirubinemia identified?

Was there over-reliance on the clinical appearance alone to detect significant hyperbilirubinemia?

Was the presence of jaundice taken seriously?

Did the parents express concerns about jaundice, poor feeding, or lethargy?

Were these concerns taken seriously?

Was the diagnosis of severe hyperbiliru-binemia made promptly once it was evident?

Was appropriate therapy started promptly after severe hyperbilirubinemia was diagnosed?