A female infant is born at 39 weeks to a 20-year-old primigravida in an uncomplicated vaginal delivery. The pregnancy had been unremarkable with normal prenatal laboratory screening results. The family history is significant for a maternal aunt who had α1-antitrypsin deficiency (AATD) diagnosed at age 20 years and died at age 54 years. The mother is blood group O+, without antibodies, and the infant’s blood group is O+. At birth, her physical examination findings are unremarkable, and she is appropriate for gestational age in all anthropometric measurements. She is given vitamin K, erythromycin is applied, and a newborn screen is sent.
Twenty-four hours after birth, the infant is visibly icteric and has decreased oral intake, but her vital signs are stable and she has otherwise normal physical examination findings. Her serum bilirubin is 7.2 mg/dL (123.1 μmol/L) and direct bilirubin is 0.9 mg/dL (15.4 μmol/L). Phototherapy and intravenous...
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