Variations of 388 G>A (Asp130Asn, rs2306283), 521 T>C (Val174Ala, rs4149056), 463 C>A(Pro155Thr, rs11045819) of the solute carrier organic anion transporter family member 1B1 (SLCO1B1) gene which encodes the hepatic solute carrier organic anion transporter 1B1, a putative bilirubin transporter, may dispose subjects to newborns hyperbilirubinemia by the limitation of hepatic bilirubin uptake ( 19– 21). Also the variation in the organic anion transporter 2 (OATP2) gene may result in severe hyperbilirubinemia in neonates ( 17, 18). For example variations in the uridine 5′-diphosphate glucuronosyltransferase 1A1 (UGT1A1) gene may cause decreased enzyme activity in neonates and adults which leads to the unconjugated bilirubin accumulation. spherocytosis, Gilbert’s syndrome, Najjar 1 and 2 Molecular genetics studies have shown the correlations between neonates hyperbilirubinemia and different genetic variations which can change in enzyme activity. The main causes of increased bilirubin mostly are: race, genetic polymorphisms inherited and acquired defects e.g. Neonatal jaundice may be on account of different parameters such as birth weight, gestational age, premature rupture of membranes, maternal infectious diseases or other illness during pregnancy, having different sources of origin, hence having different types ( 16). ![]() Five to ten percent of newborns developed jaundice required the management of hyperbilirubinemia ( 15). However, high bilirubin levels can be toxic for central nervous system development and may cause behavioral and neurological impairment (Neurotoxicity or Kernicterus) even in term newborns ( 12– 14). This condition is common in 50%–60% of newborns in the first week of life ( 8).īilirubin is not merely a nuisance molecule that has dire consequences, but bilirubin such as uric acid is an important antioxidant circulating in biologic system of neonate ( 9– 11). In neonates, the dermal icterus is first noted in the face and when the bilirubin level rises, it proceeds to the body and then to the extremities. According to National Neonatal-Perinatal Database (NNPD) the incidence of neonatal hyperbilirubinemia in in-house live-births is 3.3%, while in extramural admissions morbidity due to hyperbilirubinemia accounted for 22.1% ( 8). Therefore it can create concern in the physician and anxiety in the parents. Neonatal jaundice is the discoloration of skin and sclera color to yellowish in a newborn by bilirubin ( 7). ![]() When the total serum bilirubin (TSB) rises above the 95 th percentile for age (high-risk zone) during the first week of life, it will be considered as hyperbilirubinemia ( 4, 5).īetween 60%–80% of healthy infants are expected to present with idiopathic neonatal jaundice ( 6). Nearly 8% to 11% of neonates develop hyperbilirubinemia. ![]() Neonatal hyperbilirubinemia is a common clinical problem encountered during the neonatal period, especially in the first week of life ( 2, 3). One of the most prevalent clinical conditions in is hyperbilirubinemia ( 1).
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