Why are late preterm infants at risk for hyperbilirubinemia?

Why are late preterm infants at risk for hyperbilirubinemia?

Increased bilirubin concentrations in the blood of a preterm infant may be caused by: • Immaturity of the liver and intestinal tract, and • A decreased number of bowel movements, often resulting from reduced feeding.

What is the most common cause of hyperbilirubinemia in the newborn?

The most common causes of hemolytic jaundice include (a) Rh hemolytic disease, (b) ABO incompatibility and (c) Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency and minor blood group incompatibility.

Why do preterm infants have increased susceptibility to bilirubin encephalopathy and kernicterus compared to term infants?

Increased vulnerability due to prematurity — Preterm infants, compared with term infants, are more vulnerable to BIND at lower TB levels [7]. This increased susceptibility was first illustrated by case reports from the 1960s and 1970s in preterm infants with Rhesus isoimmune hemolytic disease [8].

How do babies get hyperbilirubinemia?

Hyperbilirubinemia happens when there is too much bilirubin in your baby’s blood. Bilirubin is made by the breakdown of red blood cells. It’s hard for babies to get rid of bilirubin at first. It can build up in their blood, tissues, and fluids.

When does kernicterus occur?

In most cases, the syndrome characteristic of kernicterus develops by three to four years of age.

Is 37 weeks late preterm?

Babies born between 37 and 42 weeks of pregnancy are called “full term.” Babies born between 34 and 36 full weeks of pregnancy are called “late preterm” babies. Your baby may look and act like a baby born on its due date, but he is not fully mature and he may have trouble in many ways.

What is the treatment for hyperbilirubinemia?

Treatment of severe episodes of hyperbilirubinemia includes intense phototherapy, exchange transfusion, plasmapheresis, and tin-mesoporphyrin. During periods of illness, kernicterus may occur at a low level of bilirubin.

What is the danger of hyperbilirubinemia?

What are possible complications of hyperbilirubinemia in a newborn? High levels of bilirubin can travel to your baby’s brain. This can cause seizures and brain damage. This is called kernicterus.

Which type of bilirubin causes kernicterus?

Kernicterus, or bilirubin encephalopathy, is bilirubin-induced neurological damage, which is most commonly seen in infants. It occurs when the unconjugated bilirubin (indirect bilirubin) levels cross 25 mg/dL in the blood from any event leading to decreased elimination and increased production of bilirubin.

Is prematurity a risk factor for hyperbilirubinemia?

Late preterm gestation is an important risk factor for the development of severe neonatal hyperbilirubinemia and kernicterus. An exaggerated hepatic immaturity contributes to the greater prevalence, severity, and duration of neonatal jaundice in late preterm infants.

Which antibiotic causes kernicterus?

One common antibiotic combines the sulfonamide sulfamethoxazole with trimethoprim (SMX-TMP) to treat bacterial infections. Studies have raised concerns that sulfonamides might increase the risk for kernicterus.

How do you know if your baby has kernicterus?

Signs & Symptoms Initial findings associated with kernicterus may vary from case to case, but often include lack of energy (lethargy) or drowsiness, poor feeding habits, fever, a shrill high-pitched cry, and/or absence of certain reflexes (e.g., Moro reflex, etc.).

Is the baby at risk for severe hyperbilirubinemia?

Babies born to mothers with diabetes or Rh disease are more likely to have this condition. Babies who underwent a difficult birthing process that resulted in significant bruising or bleeding under the scalp are also at risk for hyperbilirubinemia.

What causes unconjugated hyperbilirubinemia?

Unconjugated hyperbilirubinemia can result from increased production, impaired conjugation, or impaired hepatic uptake of bilirubin, a yellow bile pigment produced from hemoglobin during erythrocyte destruction. It can also occur naturally in newborns.

Why are preterm newborns at increased risk of infection?

Although all newborns are at an increased risk of developing infections, this is particularly true of premature babies because their immune systems haven’t fully matured. As a result, they may not be able to adequately fight off bacteria, fungi, viruses and other organisms that can cause infections.

Why to prevent preterm birth?

One way to prevent preterm birth is to prevent preterm contractions. To prevent these contractions, you must understand the factors that can cause them, such as nutrition, physical activity, stress, and certain risk factors.