HYPERBILIRUBINEMIA AND KERNICTERUS IN SMALL PREMATURE INFANTS

Abstract

Serum bilirubin levels above 15 mg/100 ml occurred in 7 of 54 infants with a birth weight of less than 1,500 gm. Definite or probable kernicterus occurred in five of these seven infants. The maximum level of indirect serum bilirubin in the five infants with kernicterus varied from 18.5 to 20.4 mg/100 ml in three infants and from 22.2 to 23.2 mg/100 ml in two. Exchange transfusions were performed in four of the five infants at levels of 18 to 22 mg/100 ml but were ineffective in preventing kernicterus. Skin hemorrhage appeared to be one of the etiologic factors causing the hyperbilirubinemia in the five infants with kernicterus. Exchange transfusion must be performed at levels of indirect bilirubin below 20 mg/100 ml if death or neurologic damage are to be prevented in the small, critically ill premature infant.