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ARTICLES:
Michael Kuzniewicz and Thomas B. Newman
Interaction of Hemolysis and Hyperbilirubinemia on Neurodevelopmental Outcomes in the Collaborative Perinatal Project
Pediatrics 2009; 123: 1045-1050 [Abstract] [Full text] [PDF]
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[Read eLetters] Neonatal hyperbilirubinemia : how high or how long for?
Francesco Raimondi   (10 March 2009)

Neonatal hyperbilirubinemia : how high or how long for? 10 March 2009
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Francesco Raimondi,
Assistant Professor of Pediatrics
Division of Neonatology, Department of Pediatrics, Università

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Re: Neonatal hyperbilirubinemia : how high or how long for?

raimondi{at}unina.it Francesco Raimondi

We have read with pleasure the study by Kuzniewicz and Newman (1) describing an increased bilirubin toxicity expressed as poorer cognitive outcomes in jaundiced infants with a positive direct antiglobulin test. Starting from a large, multiracial population of near or at-term neonates, the interaction was assessed only for a small group of Caucasian infants with maximal bilirubin ³ 25 mg/dl. At the time when much remains to be said about bilirubin and neonatal health especially in the preterm, bilirubin neurotoxicity fails once again to meet a concentration threshold. Clinicians should seriously realize that peak bilirubin is not a reliable predictor. We believe that future research should investigate the relation between exposure to bilirubin and its toxicity. It is logical to suggest that, like any drug, there may be an “area under the curve” effect and more effort is warranted to expand the preliminary evidence in support of this linkage (2).

Francesco Raimondi, Letizia Capasso, Maria Sellitto, Mariangela De Rosa

Division of Neonatology , Department of Pediatrics, Università “Federico II”, Napoli, Italy

1) Kuzniewicz M and Newman TB Interaction of hemolysis and hyperbilirubinemia on neurodevelopmental outcomes in the Collaborative Perinatal Project Pediatrics 2009 ; 123(3): 1045-1050

2) Watchko JF Kernicterus and the molecular mechanisms of bilirubin- induced CNS injury in newborns Neuromolecular Medicine 2006; 8: 513-530

Conflict of Interest:

None declared