Jaundice in Preterm Neonates

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Neonatal hyperbilirubinemia or Neonatal jaundice is a common problem encountered in the newborn period. Nearly 85% of all term and most preterm neonates become visibly jaundiced in the first week of their life. As per the Indian scenario, almost 60% of term and 80% of preterm neonates develop neonatal jaundice or hyperbilirubinemia.The word jaundice was taken from the French word "Jaune" which means yellow. Similarly, the word hyperbilirubinemia was derived from the term "Icterus", taken from Greek literature(4). The risk of hyperbilirubinemia is more in newborns due to an increase in the formation of bilirubin, which is due to increased destruction of red blood cells, defect in the elimination of bilirubin due to deranged uptake by the liver, inadequate conjugation due to immaturity of newborn and increase in entero-hepatic circulation. The risk of hyperbilirubinemia is more in preterm babies than in term babies. Due to decreased Uridine 5'-diphosphoglucuronosyltransferase UGT1A1 enzyme activity which is the enzyme responsible for the conjugation of bilirubin and making it water-soluble for its excretion leads to an increased incidence of hyperbilirubinemia in preterm infants (5, 6). A similar degree of erythrocyte turnover and heme degradation were found in preterm babies as compared to their term counterparts.