A newborn is noted to be jaundiced at 3 days of age. Which of the following factors is associated with an increased risk of neurologic damage in a jaundiced newborn?
Neonatal sepsis * Significant unconjugated serum bilirubin levels in full-term newborn infants can lead to diffusion of bilirubin into brain tissue and to neurologic damage. * Sulfisoxazole and other drugs compete with bilirubin for binding sites on albumin; therefore, the presence of these drugs can cause dislocation, not increased affinity, of bilirubin to tissues. * Administration of phenobarbital has been used to induce glucuronyl transferase in newborn infants and can reduce, rather than exacerbate, neonatal jaundice. * Other factors that reduce the amount of unconjugated bilirubin bound to albumin (and therefore cause an increase in free unconjugated bilirubin) include hypoalbuminemia and ceain compounds (e.g., nonesterified fatty acids, which are elevated during cold stress) that compete with bilirubin for albumin binding sites
Increased attachment of bilirubin to binding sites caused by drugs such as sulfisoxazole
Hyperalbuminemia
Neonatal sepsis
Maternal ingestion of Phenobarbital during pregnancy