Kernicterus - Risk Factors
Kernicterus
Risk factors
The major risk factor for the development of kernicterus is severe hyperbilirubinemia. In the full-term infant with hyperbilirubinemia due to hemolytic disease, there is a well-established correlation between the peak bilirubin level and the incidence of kernicterus. The risk of kernicterus in a term baby with hyperbilirubinemia not due to hemolysis is less definite, but clearly lower. The reason for the increased risk of kernicterus in the presence of hemolytic disease, even at an identical bilirubin level, is unknown. However, kernicterus has been well documented in recent years in term infants without hemolysis. Thus, hyperbilirubinemia itself remains the major risk factor.Additionally, prematurity is a risk factor, independent of the degree of hyperbilirubinemia. In fact, most studies demonstrate a poor to absent correlation between the bilirubin level and the occurrence of kernicterus in the premature. This may be due to factors related to prematurity itself, such as an increased neuronal susceptibility to bilirubin-induced damage or an altered blood-brain barrier, or to other conditions more often seen in the premature, such as asphyxia, acidosis, infection, hypothermia, hypoxia and hypercarbia.Return to top of page