Why it is important to recognise and treat neonatal jaundice?

Bilirubin is toxic to the brain. Uncojugated bilirubin is lipid soluble but conjugated bilirubin is water soluble.

 

Bilirubin is prevented from entering the brain by blood brain barrier under normal circumstances.

However the blood brain barrier isn't well developed in the newborn.Uncojugated bilirubin(lipid soluble) could cross to the newborn and would cause encephalopathy.(Kernicterus)

 

First of all it is important to understand Bilirubin metabolism.Please check these images

Diagram A

Diagram B

 

Causes of neonatal jaundice could be broadly categorised as

prehepatic(excessive bilirubin production)

intrahepatic(interference with conjugation)

posthepatic(reduced excretion)

 

Examples :

prehepatic:haemolytic anaemia-Rhesus incompatibility/ABO incompatibility

Intrahepatic:prematurity-liver enzymes system is immature to handle the conjucation

Post hepatic:Biliary atresia ,Choledochal cyst

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