Developmental influence of unconjugated hyperbilirubinemia and neurobehavioral disorders.
Document Type
Article
Publication Date
1-1-2019
Abstract
Bilirubin-induced brain injury in the neonatal period has detrimental effects on neurodevelopment that persist into childhood and adulthood, contributing to childhood developmental disorders. Unconjugated bilirubin is a potent antioxidant that may be useful for protecting against oxidative injuries, but it becomes a potent neurotoxin once it crosses the blood brain barrier. Because bilirubin toxicity involves a myriad of pathological mechanisms, can damage most types of brain cells, and affects brain circuits or loops that influence cognition, learning, behavior, sensory, and language, the clinical effects of bilirubin-induced neurotoxicity are likely to be manifold. One possible effect that several experts have identified is bilirubin-induced neurological dysfunction (subtle kernicterus). However, the underlying biological mechanisms or pathways by which subtle kernicterus could lead to developmental disorders has not been elucidated previously. Our aim in this review is to describe a spectrum of developmental disorders that may reflect subtle kernicterus and outline plausible biological mechanisms for this possible association. We review existing evidence that support or refute the association between unconjugated hyperbilirubinemia and developmental disorders, and limitations associated with these studies.
Publisher
Lippincott Williams & Wilkins
Publication Title
Pediatric research
ISSN
1530-0447
Volume
85
Issue
2
First Page
191
Last Page
197
Recommended Citation
Amin, Sanjiv B; Tristram Smith; and Geralyn Timler.
"Developmental influence of unconjugated hyperbilirubinemia and neurobehavioral disorders.."
Pediatric research