Advances in laboratory diagnosis of neonatal hyperbilirubinemia and peculiarities in plateau regions: a review of evidence

新生儿高胆红素血症实验室诊断的进展及高原地区特殊性:证据综述

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Abstract

High-altitude neonatal hyperbilirubinemia refers to a common condition in newborns residing at elevations of 2,500 meters or higher. This condition arises from the combination of high-altitude environmental factors-such as hypoxia and low atmospheric pressure-with physiological characteristics specific to newborns, including immature bilirubin metabolism and increased red blood cell destruction. These factors collectively lead to abnormally elevated serum bilirubin levels. However, studies on the prevalence and associated factors of neonatal hyperbilirubinemia have remained controversial due to influences from cultural, demographic, geographic, climatic, and clinical conditions. The World Health Organization recommends a one-day hospital stay after uncomplicated delivery, jaundice assessment prior to discharge, and screening for hyperbilirubinemia on the third and seventh days after birth. Due to constraints such as the harsh environment of plateau regions, regional economic deprivation, insufficient investment in medical resources, and risks associated with genetic variations among populations, implementing these recommendations proves particularly challenging in China, especially in high-altitude ethnic minority areas. Therefore, medical laboratory technology plays a pivotal role in the early screening, diagnosis, and treatment efficacy assessment of neonatal hyperbilirubinemia in high-altitude regions. This systematic review summarizes recent advances in the epidemiological characteristics, etiological mechanisms, diagnostic strategies, and therapeutic interventions for neonatal hyperbilirubinemia in high-altitude regions. It also examines the application value of rapid detection technologies and specific intervention strategies in plateau areas. Finally, it outlines future research directions, providing evidence-based guidance and practical recommendations for clinical practitioners.

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