Published online June 1, 2005
PEDIATRICS Vol. 115 No. 6 June 2005, pp. 1747-1753 (doi:10.1542/peds.2004-1748)
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SPECIAL ARTICLE

Vigintiphobia Revisited

Jon F. Watchko, MD

Division of Neonatology and Developmental Biology, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania

In this review the historical tenets and evidence-based clinical research in support of a bilirubin exchange threshold of >20 mg/dL for the healthy term neonate are revisited. In addition, a hypothesis is ventured that recent cases of kernicterus are related in part to changes in population factors coupled with genetic predispositions that have unmasked an unappreciated potential for marked neonatal hyperbilirubinemia.

Key Words: breastfeeding • genetics • hyperbilirubinemia • kernicterus

Abbreviations: TSB, total serum bilirubin • AAP, American Academy of Pediatrics • UDP-GT1A1, uridine diphosphate glucuronosyltransferase 1A1 • OATP-2, organic anion transporter protein 2

Accepted Nov 16, 2004.




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