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Neonatal Bilirubinemia in Production of Long-Term Neurological Deficits

Grace E. Holmes, MD; June B. Miller, EdD; Elbert E. Smith, MD
Am J Dis Child. 1968;116(1):37-43. doi:10.1001/archpedi.1968.02100020039005.
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ASSOCIATION of marked bilirubinemia in the early neonatal period with kernicterus is well established. The possibility has occurred to many that lesser degrees of bilirubinemia may be related to less severe cerebral injury, too mild to be detected during the newborn period, but recognizable in later years as mild to moderate impairment of intelligence, partial nerve deafness, and other neurological deficits. A closely analogous concept is that of a "continuum of reproductive casualty" developed by Pasamanick and Knobloch.1 It was the purpose of the present study to investigate the application of such a hypothesis to children with mild to moderate neonatal bilirubinemia.

In preparation for this study, the world literature was reviewed. The most significant reports are summarized in Table 1. This illustrates the conflicting results and complexities of relating moderate bilirubinemia to subsequent cerebral difficulties in surviving children. Examination of Table 1 reveals that a number of factors


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