Kernicterus in Late Preterm Infants Cared for as Term Healthy Infants
Section snippets
Pilot Kernicterus Registry
The Pilot Kernicterus Registry was initiated at the Pediatric Academic Society Kernicterus Symposium in 1992.10, 11 Voluntary reporting by colleagues, parents, and medico-legal consultations were followed by a compilation of available clinical history, medical records, case reports in the medical literature, and parent interviews. Cases are scrutinized for eligibility and to avoid duplication with strict adherence to patient and clinician privacy and confidentiality. Summarized data are entered
Results
A total of 125 eligible infants reported to the Pilot Kernicterus Registry were cared for as healthy infants and received clinically supervised services. Of these, 5 (4%) were delivered at home at maternal request. A total of 119 infants were cared for and discharged from the well baby nurseries, while 1 infant remained hospitalized. A total of 114 infants (including all 4 home births) were hospitalized within age 3 to 14 days; 3 (including one home birth) were admitted between 2 to 4 weeks
Discussion
Jaundice in late preterm infants results from an increased bilirubin load due to increased bilirubin production and/or decreased bilirubin elimination. The latter may be due to decreased hepatic uptake of bilirubin from the plasma, a delayed bilirubin conjugation, or an increased entero-hepatic circulation of bilirubin. Hyperbilirubinemia in late preterm infants is more prevalent, more severe, and its course more protracted than in term neonates and that they manifest deleterious consequences
Acknowledgments
We remember the late Audrey K. Brown, MD and value her immeasurable contributions to the initiation and maintenance of the Pilot Kernicterus Registry. We thank Karen Karp, RN, and Emidio Sivieri, MS, for their useful advice and for their dedicated work on the research database. We are grateful to the Eglin Fund at the Pennsylvania Hospital for their generous support of the Pilot Kernicterus Registry. This investigation was supported, in part, by grant number MM-00480 from the AAMC-CDC.
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