PEDIATRICS Vol. 90 No. 5 November 1992, pp. 707-715
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Kernicterus in Preterm Newborns: Past, Present, and Future

Jon F. Watchko MD1 and Frank A. Oski MD2

1 From the Department of Pediatrics, Magee-Womens Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA
2 From the Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, MD.

This historical overview of kernicterus in prematurity, from the 1950s to the present, provides a unique perspective on this clinical conundrum. Three separate periods of pediatric history are detailed in relationship to our understanding of kernicterus in the preterm newborn: (1) the pre-intensive care era (1950 to 1965); (2) the low bilirubin kernicterus era (1965 to 1982); and (3) the 1980s. Each period demonstrates selected insights regarding kernicterus in prematurity, and together with recent reports suggest that premature newborns are now at extremely low risk of developing kernicterus when managed using current standards of care. However, the current conservative empiric guidelines for preventing kernicterus are questioned, and it is suggested that additional study is needed to clarify this issue in the 1990s.

Key Words: kernicterus • prematurity • neonates • bilirubin

Submitted on December 23, 1991
Accepted on May 12, 1992




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