Kernicterus in term infants

Kernicterus is a frequent occurrence in Chinese term infants. In a previous study, the mean level of serum bilirubin of 152 kernicteric infants was 35.4 mg/dl (605.3 μmol/l) and the range was 22.3-50 mg/dl. More recently, three further term infants developed kernicterus and one exhibited bilirubin level of only 23.3 mg/dl. Features of haemolysis were lacking in 56.8% of these infants. Evidence of brain damage occurred in 26.5% in a former series and in 5.5% of the more recent study of those infants who developed bilirubinaemia exceeding 20 mg/dl. Such a high risk favours the present practice of exchange transfusion for rising bilirubin beyond 20 mg/dl (342 μmol/l) in Chinese term infants.