Physiologic jaundice of the newborn is characterized by which finding?

Physiologic jaundice of the newborn is characterized by which finding?

• A. Direct bilirubin predominates early
• B. Indirect bilirubin rises around days 3-5
• C. Jaundice occurs within the first 12 hours
• D. Total bilirubin never exceeds 5 mg/dL

Answer: (B)

Physiologic jaundice reflects immature hepatic conjugation, so bilirubin is predominantly indirect (unconjugated) and rises as the baby’s liver catches up. It almost always appears after the first 24 hours, peaks around day 3 to 5, and then gradually falls over the following days to weeks. Direct bilirubin stays low because most bilirubin is not yet conjugated, which is why the hallmark finding is a rise in indirect bilirubin around days 3 to 5. Patterns like direct bilirubin predominating early, jaundice within the first 12 hours, or total bilirubin never exceeding 5 mg/dL do not fit physiologic jaundice.

Physiologic jaundice reflects immature hepatic conjugation, so bilirubin is predominantly indirect (unconjugated) and rises as the baby’s liver catches up. It almost always appears after the first 24 hours, peaks around day 3 to 5, and then gradually falls over the following days to weeks. Direct bilirubin stays low because most bilirubin is not yet conjugated, which is why the hallmark finding is a rise in indirect bilirubin around days 3 to 5. Patterns like direct bilirubin predominating early, jaundice within the first 12 hours, or total bilirubin never exceeding 5 mg/dL do not fit physiologic jaundice.