NEONATAL HYPERBILIRUBINEMIA: ETIOPATHOGENESIS AND MANAGEMENT

Abstract

Objective: To investigate the etiopathogenesis of hyperbilirubinemia in neonates, analyzing the complications resulting from the high level of bilirubin in the patients' bodies and the appropriate treatment. Literature Review: Neonatal hyperbilirubinemia can be benign - which occurs due to the immaturity of the liver; or pathological - related to maternal and perinatal factors, such as the time of pregnancy, presence of gestational Diabetes Mellitus, preeclampsia, genetic aspects, changes in breastfeeding, congenital infections, tyrosinemia and significant weight loss of the newborn is. It affects 60 to 80% of children in the first days of life, usually due to physiological factors, but when pathological, it occurs more often in the first 24 hours. The existence of an imbalance, or ineffectiveness, in the breakdown of red blood cells and the metabolization of their waste products encompasses the pathogenesis of the condition. The severity of complications includes bilirubin-induced neurologic dysfunction, which, when free, has the potential to cross the blood-brain barrier and can lead to a spectrum of neurotoxic lesions collectively referred to as Bilirubin-Induced Neurologic Dysfunction (DNIB), which are capable of interfering with the neurologic and motor development of the neonate and leading to bilirubin encephalopathy (EB). From the most severe condition, there is the possibility of developing hearing alterations, abnormalities in motor control, oculomotor deficiencies, and tooth enamel dysplasia. Thus, the objectives of treatment are to prevent severe conditions and neurological disorders induced by bilirubin, using mainly phototherapy, which is an effective treatment that converts excess bilirubin into more water-soluble photoisomers, facilitating its excretion by the liver and kidneys of the newborn. Final Considerations: The prevention and early diagnosis of cases of neonatal jaundice are extremely relevant to avoid serious complications and unnecessary clinical interventions. Thus, there must be close monitoring of pregnant women, as well as newborns, in search of optimizing the patient's prognosis through the multidisciplinary action of trained professionals.