Perinatal aspects of bilirubin metabolism

Study of bilirubin metabolism in the fetus and newborn continues to reveal new insights into fetal physiology and maternal-fetal-neonatal relationships. Therapeutic advances directed toward prevention as well as treatment of hyperbilirubinemia continue to expand our understanding of both the basic metabolic pathways and previously unsuspected interplay between host and environment. Seemingly insignificant alterations in temperature, oxygen, carbohydrate, or light itself have been shown to affect the delicate balances in bilirubin metabolism. Similar impact upon other developing systems undoubtedly occur. Those who accept responsibility for the care of the fetus and newborn must recognize that all we do and all we fail to do in their care has a much greater potential for affecting the quality of life than at any other time.