Kernicterus in Preterm Infants

Okumura, Akihisa; Kidokoro, Hiroyuki; Shoji, Hiromichi; Nakazawa, Tomoyuki; Mimaki, Masakazu; Fujii, Kiyotaka; Oba, Hiroshi; Shimizu, Toshiaki

doi:10.1542/peds.2008-2791

Cited by 78 publications

(58 citation statements)

References 39 publications

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“…However, an increase in the survival rate of ELBW infants and advances in diagnostic technology, such as brain MRI and BAEP tests, have enabled KI to be clinically diagnosed in preterm infants in the last decade [1,4]. Okumura et al and Shapiro proposed criteria for KI based on physical and neurological examinations and laboratory findings during infancy [1,4]. In this study, serum TB and UB levels during their NICU stay for the first time were evaluated in ELBW infants with KI who were diagnosed by clinical findings, not autopsy.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical KI was diagnosed by criteria based on physical and neurological examinations, and laboratory findings during infancy, including the presence of motor impairment (dystonia, hypertonia, motor developmental delay, and/or disturbance of coordination or muscle tone) with/without athetosis, abnormal bilateral high intensity signals in the globus pallidi seen on T2-weighted images of brain MRI, and/or abnormal BAEP, such as bilateral no response or abnormal interwave separation at 90 dB [1,4]. Clinical KI infants were classified into three subtypes proposed by Shapiro [4]: classic KI, auditory KI, and motor KI.…”

Section: Subjectsmentioning

confidence: 99%

“…However, some preterm infants have been diagnosed with KI, as shown by the presence of motor impairment with athetosis, abnormal magnetic resonance imaging (MRI) and/or brainstem auditory evoked potential (BAEP) findings during infancy (clinical KI) [1][2][3][4]. Most importantly, preterm infants with KI do not always have severe hyperbilirubinemia during their stay in the neonatal intensive care unit (NICU) [1][2][3][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Serum unbound bilirubin as a predictor for clinical kernicterus in extremely low birth weight infants at a late age in the neonatal intensive care unit

Morioka

Nakamura

Koda

et al. 2015

Brain and Development

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Section: Discussionmentioning

confidence: 99%

Section: Subjectsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Serum unbound bilirubin as a predictor for clinical kernicterus in extremely low birth weight infants at a late age in the neonatal intensive care unit

Morioka

Nakamura

Koda

et al. 2015

Brain and Development

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“…However, several reports from diverse countries including Germany [60] , Holland [61] and Japan [62][63][64] comprising at least 10 VLBW infants, all ! 28 weeks' gestation with moderate hyperbilirubinemia in whom the maximal STB concentration did not exceed 272 mol/l (15.9 mg/dl) and who developed kernicterus, have recently been published and summarized by Moll et al [60] .…”

Section: Very Low Birth Weight Premature Infantsmentioning

confidence: 99%

Severe Neonatal Hyperbilirubinemia and Kernicterus: Are These Still Problems in the Third Millennium?

2011

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Despite efforts to eliminate permanent and irreversible brain damage due to bilirubin encephalopathy and kernicterus, these conditions continue to accompany us into the third millennium. This phenomenon occurs not only in developing countries with emerging medical systems, but in Westernized countries as well. Comprehensive guidelines to detect newborns with jaundice and treat those in whom hyperbilirubinemia has already developed have been formulated in several countries, but have not been successful in completely eliminating the problem. In this appraisal of the situation we review selected aspects of bilirubin encephalopathy and/or kernicterus. We highlight recent reports of severe hyperbilirubinemia and kernicterus, discuss some of the factors responsible for the continuing appearance of these conditions, and briefly review what can be done to decrease bilirubin-related morbidity and mortality to the minimum.

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“…O protocolo da instituição para realização de fototerapia nos prematuros é baseado no estudo de Okumura et al [14]. Nos recém-nascidos de termo, o protocolo utilizado é baseado nas diretrizes do National Collaborating Centre for Women's and Children's Health [15].…”

Section: Métodosunclassified

Morbidade neonatal dos recém-nascidos pré-termo tardios comparados aos de termo precoce

Lourenço¹,

Fernandes²,

Gomes³

et al. 2017

Sci Med

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Este artigo está licenciado sob forma de uma licença Creative Commons Atribuição 4.0 Internacional, que permite uso irrestrito, distribuição e reprodução em qualquer meio, desde que a publicação original seja corretamente citada. http://creativecommons.org/licenses/by/4.0/deed.pt_BR Foram excluídos recém-nascidos com malformações congênitas, ausência de acompanhamento pré-natal e internação por motivo social ou causa materna. Foi avaliada e comparada a morbidade neonatal entre os dois grupos, utilizando o teste t de Student para comparação entre médias (variáveis contínuas) e o Qui-quadrado ou teste de Fisher para comparação entre variáveis categóricas. As odds ratio (OR) com seus respetivos intervalos de confiança (IC) 95% foram ajustadas (ORa) ao peso de nascimento, tipo de parto, patologia materna e gemelaridade. Considerou-se o valor p<0.05 como estatisticamente significativo. Resultados: Foram avaliados 1.745 recém-nascidos, sendo 324 casos (RNPT-T) e 1.421 controles (RNT-P). Os RNPT-T associaram-se a maior frequência de hipertensão materna e diabetes gestacional e maiores taxas de gemelaridade e de cesariana. Os RNPT-T tiveram também um maior risco de necessidade de reanimação (OR=2,0 IC95% 1,3-3,0); hipoglicemia (ORa=4,9 IC95% 2,9-8,2); hiperbilirrubinemia (ORa=4,8 IC95% 3,7-6,2), taquipneia transitória (ORa=6,4 IC95% 4,0-10,3); dificuldades alimentares (ORa=6,6 IC95% 4,8-8,9); sepsis (ORa=4,4 IC95% 4,8-8,9); permanência hospitalar ≥5 dias (ORa=8,6 IC95% 6,6-11,3); e menor taxa de aleitamento materno exclusivo (ORa=0,2 IC95% 0,15-0,3). Conclusões: Em comparação aos RNT-P, os RNPT-T apresentaram maior risco de morbidade. Este estudo reforça a necessidade de um seguimento clínico apropriado aos RNPT-T no período neonatal. Morbidade neonatal dos recém-nascidos pré-termo tardios comparados aos de termo precoceDESCRITORES: recém-nascido; prematuro; morbidade. ABSTRACT Aims:To evaluate and compare neonatal morbidity between late-preterm infants (LPTI) and early term infants (ETI). Methods: Retrospective cross-sectional study, including live births at a regional referral maternity hospital in Portugal, in the years 2014 and 2015, with gestational age between 34 0/7 and 38 6/7 weeks. LPTI (34 0/7 -36 6/7 weeks) were considered as cases and ETI (37 0/7 -38 6/7 weeks) were considered controls. Neonates with congenital malformations, lack of prenatal care and hospitalization for social/maternal reasons were excluded. We evaluated and compared neonatal morbidity between the two groups, using Student's t-test for comparison between means (continuous variables) and Chi-square or Fisher's test for comparison between categorical variables. Odds ratio (OR) was calculated and adjusted (aOR) to birth weight, maternal disease, type of birth and multiple pregnancy. A value of p <0,05 was considered of statistical significance. Results: A total of 1,745 neonates were evaluated: 324 cases (LPTI) and 1,421 controls (ETI). LPTI was associated with a higher frequency of maternal hypertension and gestational diabetes and higher rat...

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Kernicterus in Preterm Infants

Cited by 78 publications

References 39 publications

Serum unbound bilirubin as a predictor for clinical kernicterus in extremely low birth weight infants at a late age in the neonatal intensive care unit

Serum unbound bilirubin as a predictor for clinical kernicterus in extremely low birth weight infants at a late age in the neonatal intensive care unit

Severe Neonatal Hyperbilirubinemia and Kernicterus: Are These Still Problems in the Third Millennium?

Morbidade neonatal dos recém-nascidos pré-termo tardios comparados aos de termo precoce

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