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Neonatal jaundice is perhaps the most common of all pediatric problems and hazardous levels of unconjugated bilirubin pose a direct threat of permanent brain damage (kernicterus). Current population-based kernicterus estimates of the prevalence for term neonates in developed countries range from approximately 1:50,000 to 1:200,000. In low- and middle-income countries, although the prevalence is unknown, kernicterus appears to be a much more serious problem. Thus, the prevention of kernicterus remains a concern for neonatal caregivers worldwide.

In addition, it is now increasingly apparent that some neonatal hyperbilirubinemia is the result of complex gene–environment interactions and that the molecular pathogenesis of bilirubin-induced neurotoxicity follows a cascade of events not previously appreciated. This volume was designed to bring together the relevant basic science and clinical information necessary for understanding the genesis of neonatal hyperbilirubinemia and bilirubin-induced brain damage as well as information regarding care of the jaundiced neonate. We are fortunate to have recruited outstanding experts in the field who share their insightful perspectives based on current knowledge and extensive clinical experience, so that this book can serve as an essential reference for both practitioners and investigators.

This volume addresses a broad array of interrelated topics, ranging from the genetics, biochemistry, transport, and metabolism of bilirubin to neonatal hyperbilirubinemia, public policy measures, clinical management, and interventions designed to prevent and treat neonatal hyperbilirubinemia and to reduce the burden of bilirubin encephalopathy in developed and low- and middle-income countries. The pathobiology of bilirubin-induced neurotoxicity, the clinical diagnosis and outcome of kernicterus, and the important contributions of hemolytic disease and glucose-6-phosphate dehydrogenase deficiency to neonatal hyperbilirubinemia are detailed. The book also includes discussion of risk assessment and treatment with phototherapy and other modalities. Collectively the chapters complement each other; they point out gaps in knowledge as well as consensus regarding practice. We hope that this book provides both the clinician and the investigator with a firm basis for future study and the stimulus to move the field forward.

David K. Stevenson, MD
M. Jeffrey Maisels, MB BCh, DSc
Jon F. Watchko, MD

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