Jaundice is the most common and one of the most annoying problems that can occur in the newborn. Although most jaundiced infants recover without any serious problem, there is always a risk of
bilirubin encephalopathy during the period of
hyperbilirubinemia. The relationship between
encephalopathy and serum free
bilirubin levels was investigated in 83 newborn infants (40 premature, 43 mature) with unconjugated
hyperbilirubinemia. A complete physical examination was done in all patients, and signs of
bilirubin encephalopathy were noted if present. The serum free
bilirubin level exceeded 0.1 mg/dl in 13 infants, and 12 of them showed signs of
encephalopathy. On the other hand, none of the infants whose serum free
bilirubin levels were below 0.1 mg/dl showed signs of
encephalopathy. Although there is a significant positive correlation between serum total and free
bilirubin levels, it is not clear at what total
bilirubin level free
bilirubin will appear. Serial determinations of free
bilirubin appear to be more helpful in the management of
hyperbilirubinemia in infants with an increased risk of
bilirubin toxicity.