[Critical study of erythrocyte bilirubin and predictive factors of kernicterus in premature low birth weight infants].
Among 217 premature neonates with birth-weights less than or equal to 1,500 g who died, in whom post mortem examination was carried out during the years 1978-1984, 11 cases of kernicterus (5%) were found. A comparative study was undertaken between these 11 children and 42 children of the same population matched for birth-weight, gestational age and life duration. The following clinical and biological perinatal data were found more frequently in the kernicterus group: meningitis (3/11 vs 0/42), p less than 0.01), hyperchloronatremic dehydration (3/11 vs 1/42, p less than 0.05) and hypoglycemia either severe (less than 0.83 mumol/l) (5/11 vs 3/42, p less than 0.01) or prolonged (less than 1.66 mumol/l for at least 36 hrs) (3/11 vs 0/42, p less than 0.01). The mean value of total bilirubin highest levels was 261 +/- 76 mumol/l in cases with kernicterus and 266 +/- 58 mumol/l in the control group (NS). In a case with kernicterus the total bilirubin level was 149 mumol/l (87 mg/l). Erythrocyte bilirubin was repeatedly assayed in 16 children, 4 of which were found to have kernicterus. There was no significant difference in the mean maximum peak of erythrocyte bilirubin between the 2 groups (kernicterus group: 17.8 +/- 3.4 mumol/l in the 4 cases with kernicterus. Finally, hypoglycemia, respiratory and/or metabolic acidosis were found associated with the highest erythrocyte bilirubin level, or during the 24 preceding hours in children with kernicterus only.
Dubois
B
B
Service de réanimation néo-natale, Hôpital Port-Royal, Paris.
Sender
A
A
Pajot
N
N
Moriette
G
G
Larroche
J C
JC
D000138:Acidosis / Q000150:complications; D000142:Acidosis, Respiratory / Q000150:complications; D001663:Bilirubin / Q000097:blood*; D002712:Chlorides / Q000097:blood; D004912:Erythrocytes / Q000032:analysis*; D006801:Humans; D006955:Hypernatremia / Q000150:complications; D007003:Hypoglycemia / Q000150:complications; D007230:Infant, Low Birth Weight / Q000097:blood*; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000097:blood*; D007647:Kernicterus / Q000097:blood* / Q000150:complications; D008581:Meningitis / Q000097:blood / Q000150:complications
D002712:Chlorides; D001663:Bilirubin
Etude critique de la bilirubine érythrocytaire et des facteurs prédictifs de l'ictère nucléaire chez le prématuré de faible poids de naissance.