The risk of bilirubin encephalopathy, as estimated by plasma parameters, in neonates strongly suspected of having sepsis

Abstract

The study comprises 18 mature newborns, strongly suspected of having sepsis, and a control group of 18 mature, healthy newborns with the same postnatal age. The object of the investigation was to compare the risk of development of bilirubin encephalopathy between the two groups, as estimated by plasma parameters. The sepsis group had significantly lower reserve albumin concentration for binding of MADDS (p < 0.01) and significantly lower total albumin concentration (p < 0.01). No significant differences were observed in unconjugated bilirubin concentration and plasma pH. It is suggested that mature newborns with sepsis have a slightly increased risk of developing bilirubin encephalopathy.

Cephalocaudal Progression of Jaundice in Newborns Admitted to Neonatal Intensive Care Units

“…Newborns with sepsis or asphyxiated at birth have slightly lower reserve albumin con centrations compared to control groups [8,14] and, according to the theory, higher ce phalocaudal color gradients. However, this was not found.…”

“…Asphyxia was de fined as 1-min Apgar score < 3 and/or five minute Apgar score < 5. Respiratory' distress syndrome, was defined according to Hjalmarson [7], Neonates with clinical symptoms of infection and on antibiotic treat ment were classified as being suspected of infection, neonates with negative bacterial cultures but with a plasma C reactive protein concentration > 4 0 mg/l (normal < 15 mg/l) were classified as being strongly suspected of infection and neonates with positive bac terial cultures were classified as having proven infec tion [8], A blood glucose concentration < 1.7 mmol/1 was considered hypoglycemic.…”

Late neurological sequelae of non-hemolytic hyperbilirubinemia of healthy term neonates

“…The design of such studies makes correction for confounding variables difficult. Prematurity, sepsis and hemolytic disease have been shown to increase the risk of bilirubin encephalopathy (7,(9)(10)(11).…”

Low bilirubin kernicterus with sepsis and hypoalbuminaemia

“…While not all causes of jaundice are risk factors for ABE, sepsis on its own has been identified as a major risk factor for ABE in neonates. A study comparing 18 mature infants with confirmed sepsis against a control group suggested that even though there were no significant differences in the unconjugated bilirubin (UCB) concentration and plasma pH in both groups, there was a slight increased risk of bilirubin encephalopathy in the group with sepsis 3. This is thought to be because of a significant reduction in the albumin concentration, as well as a reduction in albumin binding capacity because of sepsis 3…”