Factores de riesgo y complicaciones asociadas a kernicterus en neonatos

Abstract

Introduction: About 60% of healthy newborns delivered at term will develop recognizable jaundice. In this case, serum total bilirubin concentration (STB) can be expected to be at least 5 to 7 mg/dl; in most cases, STB will not exceed the physiological range, but occasionally, it can rise to very high levels and pose a threat to the newborn by entering the central nervous system tissues, thus causing kernicterus or bilirubin encephalopathy. Objective: To analyze the risk factors and complications associated with kernicterus in neonates through a systematic review. Methodology: A non-experimental, descriptive study was conducted, which reported risk factors and complications associated with kernicterus in neonates from 2018 to 2023 in English and Spanish based on the PRISMA 2020 method. Results: The results of this study were obtained from 35 articles. The most critical risk factor for neurotoxicity is the severity and duration of bilirubin exposure. The risk is most significant with STB ≥30 mg/dL (513 micromol/L). The main consequence of severe neonatal hyperbilirubinemia is a spectrum of neurotoxic lesions termed bilirubin-induced neurological disorders. The clinical spectrum varies from subtle findings to severe permanent disability. Conclusions: Elevated bilirubin levels occur in almost all neonates and may occur with visible jaundice; neonates with severe hyperbilirubinemia (BTS >25 mg/dL or 428 micromol/L) are at risk for developing bilirubin neurotoxicity; however, if hyperbilirubinemia in this range is not treated promptly, it can lead to severe permanent neurologic injury.