Neonatal hyperbilirubinemia.

Care of the high-risk neonate usually refers to the low-birth-weight infant or the sick term newborn. Whereas hyperbilirubinemia is certainly a matter of concern in these infants, the decisions that must be made regarding jaundice in the high-risk neonate are, in general, less complex than those that must be made for the healthy full-term infant. For the term and near-term infant, shorter hospital stays, the need for outpatient surveillance and management, and the occasional disturbing case of extreme hyperbilirubinemia and even kernicterus raise new issues in the management of neonatal jaundice. Bilirubin has both salutary and toxic effects. At physiologic levels it exerts important antioxidant effects ,107. 113 and, although its toxic effects are well documented, there are also some concerns that aggressive use of phototherapy in very lowbirth-weight infants may not be entirely innocuous.v'