Efecto de la hiperbilirrubinemia sobre los ritmos biológicos en recién nacidos a término sanos
- Javier Aldana Gómez 1
- M. Revilla Ramos 1
- Jesús María Andrés de Llano 1
- María Paz Aragón García 1
- Julio Ardura Fernández 1
-
1
Universidad de Valladolid
info
ISSN: 0302-4342
Año de publicación: 1998
Volumen: 48
Número: 4
Páginas: 389-394
Tipo: Artículo
Otras publicaciones en: Anales españoles de pediatría: Publicación oficial de la Asociación Española de Pediatría ( AEP )
Resumen
Fundamento: la toxicidad de la bilirribian sobre el cerebro presenta aspectos desconocidos. Por ello el tratamiento de la ictericia neonatal es controvertido. Pretendemos averiguar si la bilirrubina provoca toxicidad sobre los centros cerebrales que regulan los ritmos biológicos (RB) en recién nacidos sanos a término. Conclusiones: al relacionar la elevación de la bilirrubina en el neonato con la disminución de la incidencia de los RB, los resultados no mostraron la relación buscada y son un argumento más en contra del efecto neurotóxico de valores moderados de la bilirrubina. Junto a la escasa evidencia de alteraciones a largo plazo, permite hacer un pronóstico neurológico más optimista en recién nacidos a término con elevación moderada de la bilirrubina.
Referencias bibliográficas
- Lucey JF. Different opinions and thoughts on the management of hyperbilirubinemia. Pediatrics 1992; 89:974
- Lucey JF. Bilirubin and brain damage-A real mess. Pediatrics 1982; 69:381-382
- Newman TB, Maisels MJ. Does hyperbilirubinemia damage the brain of healthy full-term infants? Clin Perinatol 1990; 17:331-358
- Newman TB, Maisels MJ. Evaluation and treatment of jaundice in the term newborn. Pediatrics 1992; 89:809-818
- Poland RL. In search of a gold standard for bilirubin toxicity. Pediatrics 1992; 89:823
- Gartner LM, Catz CS, Yaffe SJ. Neonatal bilirubin workshop (Rockefeller University, New York, 1993). Pediatrics 1994; 94:537-540
- Vohr BR. New approaches to assessing the risk of hyperbilirubinemia. Clin Perinatol 1990; 17:293-304
- Takahashi J, Zatz M. Regulation of circadian rhythm. Science 1982; 217:1104-1111.
- Moore-Ede MC, Sulzman FM, Fulller CA. The clocks that time us: Physiology of the circadian timing system. Harvard University Press. Massachussets, 1982
- Moore R. The suprachiasmatic nucleus and the organization of a circadian system. Trends Neurosci 1982; 5:404-407
- Enright J. Temporal precision in circadian system: A reliable neuronal clock form unreilable components? Science 1980; 209:1542-1545
- Rusak B, Zucker I. Neural regulation of circadian rhythms. Physiol Rev 1979; 59:449-526
- Lydic R, Schoene WC, Czeisler CA, Moore-Ede MC. Suprachiasmatic region of the human hypothalamus: homolog to the primate circadian pacemaker? Sleep 1980; 2:355-361
- Aldana J. Influencia de los factores ambientales y de la edad gestacional, en el desarrollo de los ritmos biológicos del prematuro, durante el primes mes de vida. Tesis Doctoral. Universidad de Valladolid, España, 1992.
- Ardura Femández J, Andrés de Llano JM, Aldana Gómez J, Revilla Ramos MA, Bretaña Casado ML, González Suárez J. Ritmo biológico de la frecuencia respiratoria en el primer trimestre de la vida. An Esp Pediatr 1992; 37:377-382.
- Anders TF. Biological rhythms in development. Psychosom Med 1982; 44:61-72
- Halberg F. Chronobiology. Annu Rev Physiol 1969; 31:675-725.
- Aschoff J, Daan S, Groos GA. Vertebrate circadian system. Science 1983; 220:854-855
- Mills JN. Development of circadian rhythms in infancy. Chronobiologia 1975; 2:363-371
- Aschoff J.Circadian rhythms in man. Science 1965; 148:1427-1432.
- Aldana Gómez J, Andrés de Llano J, Villamañán de la Cal I, Revilla Ramos MA, Ardura Fernández J. Valores de referencia basados en series temporales de neonatos pretérmino. An Esp Pediatr 1994; 40:428-434.
- Ardura Fernández J, Andrés de Llano J, Aldana Gómez J, Brelaña Casado ML, Revilla Pastor MA, Aragón García MP. Valores de referencia basados en series temporales. An Esp Pediatr 1994; 41:333-340.
- Nelson W, Tong YL, Lee JK, Halberg F. Methods for Cosinor Rhythmometry. Chrononobiologia 1979; 6:305-323.
- Hsia DY-Y, Allen FH, Gellis SS et al. Erythroblastosis fetalis. VIII. Studies of serum bilirubin in relation to kernicterus. N Engl J Med 1952; 247:668-671
- Watchko JF, Oski FA. Bilirubin 20 mg/dl=vigintiphobia. Pediatrics 1983; 71:660-663.
- Seidman DS, Paz I, Stevenson DK et al. Neonatal hyperbilirubinemia and physical and cognitive performance at age 17 years. Pediatrics 1991; 88:828-833
- Boggs T, Hardy J, Frazier T. Correlation of neonatal serum total bilirubin concentration and developmental status at age eight months. Preliminary report from the collaborative project. J Pediatr 1967; 71:553-560.
- Scheidt PC, Mellits ED, Hardy JB et al. Toxicity to bilirubin in neonates. Infant development during the first year in relation to maximum neonatal serum bilirubin concentration. J Pediatr 1977; 91:292-297
- Hardy JB, Peeples MO. Serum bilirubin levels in newborn infants: Distributions and associations with neurological abnormalities during the first year of life. John Hopkins Med J 1971; 128:265-272
- Naeye RL. The role of congenital bacterial infections in low serum bilirubin brain damage. Pediatrics 1978; 62:497-503.
- Rubin RA, Balow B, Fisch RO. Neonatal serum bilirubin levels related to cognitive development at ages 4 through 7 years. J Pediatr 1979;601-604.
- National Institute of Child Health and Human Development. Randomized, controlled trial of phototherapy for neonatal hyperbilirubinemia. Pediatrics 1985; 72(suppl):384-441
- Culley P, Powell J, Waterhouse J et al. Sequelae of neonatal jaundice. Br Med J 1970; 3:383-386
- Holmes GE, Miller JB, Smith EE. Neonatal bilirubinemia in production of long-term neurological deficits. Am J Dis Child 1968; 116:37-43
- Newman TB, Klebanoff MA. Neonatal hyperbilirubinemia and long-term outcome: another lok at the Collaborative Perinatal Project. Pediatric 1993; 92:651-657
- Lester BM. Developmental outcome prediction from acoustic cry analysis in term and preterm infants. Pediatrics 1987; 80:529-534
- Vohr BR, Lester B, Rapisardi G. Abnormal braimstem function (BAER) correlates with acoustic cry features in term infants with hyperbilirubinemia. J Pediatr 1989; 115:303-308.
- Koivisto M. Cry analysis in infants with Rh Haemolytic disease. Acta Paedtr Scand 1987; 335:1-166.
- Paludetto R, Mansi G, Rinaldi P. The behavior of jaundiced infants treated with phototherapy. Early Hum Dev 1983; 8:259-267.
- Brazelton TB. Neonatal behavioral assessment scale. En Brazelton TB (Ed): Clinics in Development Medicine. Philadelphia, JB Lippincott, 1973: 1-114.
- Maisels MJ. Neonatal Jaundice. En Avery GB (ed): Neonatology Pathophysiology and Management of the Newborn. Philadelphia, JB Lippincott, 1987: 534-629