title: Apnea in acute bilirubin encephalopathy.
abstract: Central apnea, defined as cessation of breathing for ≥20s, is frequent in premature infants born at <34 weeks׳ gestation but uncommon among healthy late preterm (34(0/7)-36(6/7) weeks׳ gestation) and term (≥37 weeks׳ gestation) infants, where it is usually a clinical manifestation of a neurological or metabolic problem. There is growing evidence that marked unconjugated hyperbilirubinemia is associated with central apnea in neonates. This article explores the reported association between acute bilirubin encephalopathy and symptomatic apneic events in newborns and the possible mechanisms involved in the pathogenesis of this phenomenon. The prevalence of symptomatic apneic events in reports of acute bilirubin encephalopathy suggests this clinical finding should be considered a sign of bilirubin neurotoxicity.
authors.affiliation: Division of Neonatal Medicine, Department of Pediatrics, University of Rochester, Rochester, NY.
authors.forename: Sanjiv B
authors.initials: SB
authors.lastname: Amin
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics Lucile Packard Children׳s Hospital at Stanford University, Stanford University, Palo Alto, CA.
authors.forename: Vinod K
authors.initials: VK
authors.lastname: Bhutani
authors.affiliation: Division of Newborn Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Magee-Womens Hospital, 300 Halket St, Pittsburgh, PA 15213. Electronic address: jwatchko@mail.magee.edu.
authors.forename: Jon F
authors.initials: JF
authors.lastname: Watchko
mesh_terms: D001049:Apnea / Q000453:epidemiology* / Q000209:etiology; D001663:Bilirubin / Q000097:blood; D005865:Gestational Age; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000150:complications*; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases; D007647:Kernicterus / Q000150:complications*
chemical_list: D001663:Bilirubin
keywords: brainstem; kernicterus; respiratory control; unbound bilirubin