PATHOPHYSIOLOGY OF NEONATAL HYPERBILIRUBINEMIA

The most important steps of bilirubin metabolism involved in the patho physiology of neonatal hyperbilirubinemia are: 1) hemoglobin degradati on by heme oxygenase; 2) bilirubin binding to serum albumin; 3) biliru bin conjugation to acid glucoronic by glucoronyl transferase. Progress e in the knowledge of these metabolic steps allows to understanding of why massive hemolysis, infections, hypoxia and prematurity increase t he risk of kernicterus and therefore justify adapted preventive and th erapeutic measures. (C) 1998 Elsevier, Paris.