HYPERBILIRUBINEMIA IN INFANTS

Abstract

To the Editor:— Recently we became aware of an association between the administration of large amounts (72 mg.) of a vitamin K analogue, menadione sodium bisulfite (Hykinone), intravenously to mothers in labor and the occurrence of marked, early hyperbilirubinemia in newborn premature infants. We have encountered seven such cases, the details of which are listed in the table. These infants were first noted to have markedly elevated levels of serum bilirubin between 40-72 hours of age. All but one were treated with exchange transfusionin an effort to prevent neurological damage (kernicterus) from the hyperbilirubinemia. Under ordinary conditions jaundice of this degree does not occur until the fourth to sixth day of life. There is adequate evidence in the literature to show that vitamin K analogues are capable of causing hyperbilirubinemia when administered in large amounts to premature infants. Inasmuch as doses as small as 1-10 mg. given by