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Neonatal Hyperbilirubinemia in Preterm Neonates

Neonatal Hyperbilirubinemia In Preterm Neonates: An Issue Of Clinics In Perinatology


Preterm neonates remain at increased risk for adverse bilirubin-related outcomes, including acute bilirubin encephalopathy relative to term infants. Yet, most vulnerable neonates are likely to benefit from the potent anti-oxidant properties of bilirubin. Evidence-based guidelines for the management of hyperbilirubinemia in preterm infants, however, are lacking. High concentrations of unconjugated bilirubin can cause permanent neurologic damage in infants, evident through magnetic resonance imaging of chronic bilirubin encephalopathy or kernicterus. There is a growing concern that exposures to even moderate concentrations of bilirubin may lead to subtle but permanent neurodevelopmental impairment referred to as bilirubin-induced neurologic dysfunction. Our current use of phototherapy to decrease bilirubin loads and its potential photo-oxidant properties is a biological conundrum that has been questioned in the use of phototherapy for very low birth weight neonates. In this issue of Clinics in Perinatology, we provide updates on the current understanding of the biology, mechanisms of increasing bilirubin load due to hemolysis, decreased bilirubin binding capacity and glucose-6-phosphate dehydrogenase deficiency, as well as clinical strategies to operationalize the thresholds for hyperbilirubinemia interventions in preterm infants.



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    Conditions Guide
  • Format: Hardcover
  • Sold by: --
  • Language: English
  • Publisher: Elsevier Science Health Science
  • ISBN-13: 9780323446280
  • ISBN: 0323446280
  • Publication Year: 2016
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HPB condition ratings
  • New: Item is brand new, unused and unmarked, in flawless condition.
  • Fine/Like New (F): No defects, little usage. May show remainder marks. Older books may show minor flaws.
  • Very Good (VG): Shows some signs of wear and is no longer fresh. Attractive. Used textbooks do not come with supplemental materials.
  • Good (G): Average used book with all pages present. Possible loose bindings, highlighting, cocked spine or torn dust jackets. Used textbooks do not come with supplemental materials.
  • Fair (FR): Obviously well-worn, but no text pages missing. May be without endpapers or title page. Markings do not interfere with readability. Used textbooks do not come with supplemental materials.
  • Poor (P): All text is legible but may be soiled and have binding defects. Reading copies and binding copies fall into this category. Used textbooks do not come with supplemental materials.
Conditions Guide
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