The Hue of Yenidoğan Might Offer an Evolutionary Edge!

In a groundbreaking discovery, a team led by liver microbiologist Richard Hansen at Aberdeen University has proposed that the high levels of bilirubin in newborns, responsible for causing jaundice, might actually be cleaning the blood and acting as a natural defense mechanism against sepsis.

Neonatal sepsis, a serious condition that occurs when a newborn baby struggles against certain bacteria and infections, is a leading cause of morbidity and mortality in newborns, especially during the critical early days of life.

The team's findings, published in the journal Scientific Reports, suggest that the elevated bilirubin levels in newborns could be serving a protective role. This is based on the antioxidant and immunomodulatory properties of bilirubin, the substance that causes jaundice.

Neonatal jaundice occurs when bilirubin accumulates due to the immature liver's slow processing ability. During the first week of life, this hyperbilirubinemia peaks, a period when newborns are particularly vulnerable to infections like sepsis. Bilirubin's antioxidant effects can protect tissues from oxidative damage during infections, while its antimicrobial potential may directly prevent bacterial proliferation in the bloodstream or tissues.

The evolutionary significance of neonatal jaundice in preventing sepsis is hypothesized to be related to these properties. Mild jaundice in newborns, particularly premature ones, may help protect them from more severe clinical outcomes such as sepsis by disrupting the growth of certain bacteria.

Hansen's research found that bilirubin reduced the growth of the bacterial strain Streptococcus agalactiae, which can cause early sepsis in babies, by about half. It also inhibited the growth of certain Staphylococcus strains.

While the research does not address whether the protective effects of bilirubin apply to all types of infections or only to those related to sepsis, it adds to the understanding of how mild jaundice in newborns helps protect premature babies from more severe clinical outcomes.

However, it's important to note that if not treated, newborn jaundice can affect the baby's brain and lead to developmental problems. Therefore, the management of neonatal hyperbilirubinemia carefully balances preventing toxic bilirubin levels and preserving any potential protective benefits.

The findings of Hansen's research suggest that the natural increase in bilirubin levels in the first few days after birth could be the body's natural response to sepsis. Further research is needed to confirm the exact mechanism by which bilirubin protects newborns from sepsis and to determine its full implications for neonatal health.

References:

Hansen, R., et al. (2022). Evolutionary significance of neonatal jaundice in preventing sepsis. Scientific Reports.
American Academy of Pediatrics. (2018). Management of hyperbilirubinemia in the term newborn. Pediatrics.
World Health Organization. (2019). Neonatal sepsis. Retrieved from https://www.who.int/news-room/fact-sheets/detail/neonatal-sepsis
Hibberd, P. L., et al. (2015). Neonatal jaundice. Lancet.
Mayo Clinic. (2021). Gilbert syndrome. Retrieved from https://www.mayoclinic.org/diseases-conditions/gilbert-syndrome/symptoms-causes/syc-20354261
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