Which condition is associated with prolonged neonatal jaundice that may last into the fourth week of life?

Prolonged neonatal jaundice that lasts beyond the first week of life is often indicative of specific underlying conditions. Hypopituitarism is associated with prolonged jaundice due to the hormonal imbalances it creates in the neonate. This condition results from underdevelopment or damage to the pituitary gland, leading to reduced production of hormones that regulate various body functions, including the adrenal hormones that affect metabolism and, consequently, bilirubin processing.

In newborns, jaundice is primarily caused by the immature hepatic processing of bilirubin. When the hormonal support is inadequate due to hypopituitarism, the liver may have decreased capability to handle and conjugate bilirubin effectively, resulting in elevated bilirubin levels. Prolonged jaundice can thus be a clinical manifestation of this condition, persisting into the fourth week of life if the underlying hormonal deficits are not addressed.

In contrast, the other conditions listed typically do not present with prolonged neonatal jaundice in the same way. For example, tricuspid atresia primarily affects cardiac function, and congenital adrenal hyperplasia involves adrenal insufficiency but is usually associated with salt-wasting rather than prolonged jaundice. Fanconi anemia can present with varied hematologic abnormalities but is not primarily associated with persistent jaundice