THE CEPHALOCAUDAL PROGRESSION OF JAUNDICE IN NEWBORNS IN RELATION TO THE TRANSFER OF BILIRUBIN FROM PLASMA TO SKIN

The cephalocaudal progression of jaundice was studied in 136 mature, clinically well newborns. The yellow colour of the skin was measured with the transcutaneous bilirubinometer. Significant positive correlation was found between the yellow colour of the skin in four regions and the plasma bilirubin concentration (forehead: rho = 0.83, abdomen: rho = 0.89, knee: rho = 0.82, and foot: rho = 0.65, all P < 0.00001). The values obtained from the forehead were significantly higher than the values obtained from the abdomen (P < 0.0001), the knee (P < 0.00001), and the foot (P < 0.00001). The cephalocaudal progression of jaundice correlated positively with the plasma bilirubin concentration (rho = 0.58, P < 0.00001) and inversely with the gestational age (rho = -0.28, P < 0.01). The results support a proposed hypothesis explaining the cephalocaudal progression of jaundice in newborns. According to the hypothesis, the cepholocaudal colour difference may be caused by the presence of young bilirubin-albumin complexes in the blood undergoing conformational changes. © 1990.