RT Book, Section
A1 Maisels, M. Jeffrey
A1 Newman, Thomas B.
A2 Stevenson, David K.
A2 Maisels, M. Jeffrey
A2 Watchko, Jon F.
SR Print(0)
ID 56323199
T1 Chapter 9. Prevention, Screening, and Postnatal Management of Neonatal Hyperbilirubinemia
T2 Care of the Jaundiced Neonate
YR 2012
FD 2012
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-176289-2
LK accesspediatrics.mhmedical.com/content.aspx?aid=56323199
RD 2024/04/19
AB As  noted  in  several  other  chapters  in  this  book,  bilirubin  encephalopathy  and  kernicterus  are  still  occurring  throughout  the  world  with  population-based  estimates  of  incidence  in  North  America  and  Europe  ranging  from  0.5  to  2.4  cases  per  100,000  live  births1  (Table  9-1).  In  contrast  to  the  early  clinical  case  descriptions,  most  of  the  infants  who  now  develop  kernicterus  are  not  those  with  Rh  disease  and  they  often  have  no  documented  evidence  of  hemolytic  disease.9  Many  are  term  and  late  preterm  infants  who  have  been  discharged  from  the  nursery  as  “healthy  newborns,”  yet  have  returned  to  a  pediatrician's  office,  a  clinic,  or  an  emergency  department  with  total  serum  bilirubin  (TSB)  levels  often  exceeding  30  mg/dL9—and  have  gone  on  to  develop  the  classic  neurodevelopmental  findings  associated  with  kernicterus.10  There  is  also  a  smaller  group  of  infants,  more  difficult  to  identify,  who  suffer  an  unanticipated  precipitous  increase  in  the  TSB  while  still  in  the  hospital  or  soon  after  discharge  and  present  with  acute  bilirubin  encephalopathy.9,11,12  Glucose-6-phosphate  dehydrogenase  (G6PD)  deficiency  is  an  important  cause  of  the  hyperbilirubinemia  in  some  of  these  infants.9,12