Neonatal Jaundice and Kernicterus

Studies on the Relation Between Serum and Spinal Fluid Bilirubin During Early Infancy1

“…Similarly, the increased incidence of kernicterus among unsensitized prematures (36)(37)(38)(39)(40)(41)(42) has been attributed to hyperbilirubinemia on a physiological basis (22,43). Vogel (44) has suggested that kernicterus occurs in such infants because: 1) There is an increased permeability of the blood-brain barrier for bilirubin during early infancy, and 2) the bilirubin is reduced within the brain to mesobilirubin, which gives rise to the cerebral pigmentation in kernicterus.…”

Pediatrics

“…Studies on the mechanism for production of kernicterus have further implicated excessively high serum levels of bilirubin as a direct etiologic factor (184,185,186). One report suggests that perhaps hyperbilirubinemia of "physiologic" jaundice may occasionally be related to production of kernicterus among otherwise normal newborn infants (187). Even though kernicterus associated with hemolytic disease may be virtually eliminated through skillful exchange transfusions, there remains the possibility of an increased incidence of mental retardation or other central nervous system disorder as a complication of this disease.…”