Hyperbilirubinemia and urinary D-glucaric acid excretion in premature infants following antepartum dexamethasone treatment

Dexamethasone (10 mg i.m.) administered to mothers 24 hours before delivery for the prevention of respiratory distress syndrome caused a considerable elevation of the serum level of unconjugated bilirubin in premature infants throughout the first week of life. On days 3 to 4 the incidence of infants with bilirubin levels exceeding 256.56 micrometer/l (15 mg/100 ml) was found to increase (7/15 vs 2/17). The urinary excretion of D-glucaric acid, which reflects the activity of the hepatic microsomal enzyme systems, proved to be low in pre-term infants over the first 7 days of life, and it was not enhanced significantly by antenatal dexamethasone therapy. In the light of the results presented, more detailed clinical and experimental analysis of the effects of glucocorticoids on bilirubin metabolism of pre-term infants and investigation into the drug prophylaxis of steroid-induced hyperbilirubinaemia are suggested.