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Bilirubin metabolism in the fetus
Open accessAbstract
Although the kinetics of fetal erythropoiesis and the life span of fetal erythrocytes have not been accurately determined, thus precluding a quantitative appraisal of bilirubin production in the fetus, there is convincing evidence that this pigment is formed during intrauterine life. Sup-porting this are the presence of bilirubin in me-conium (2), in fetal plasma (3) and the fetal gall bladder (4), and the elevated mean bilirubin concentrations in fetal and cord blood as compared to those in maternal blood (3, 5). On the other hand, in fetal liver the enzymatic apparatus for glucuronide formation is functionally deficient (6), which is believed to interfere with pigment excretion in the fetal bile (7). Despite this "immaturity " of the fetal liver, bilirubin levels in cord blood are surprisingly low (8), even in instances of erythroblastosis in which manifest hemolysis had occurred in utero (9). Shortly af-ter birth, however, the level of unconjugated bili-rubin in the neonatal serum rises steeply, reaching peak values during the first week of life (8). These observations suggest that during intra-uterine life fetal bile pigment is disposed of by mechanisms other than biliary excretion, and they point to the placenta as a likely route of elimina-tion (10). Previous investigations found human and rat placenta to lack the enzymatic mechanism for glucuronide formation (10), indicating that in fetal bile pigment metabolism, the placenta does * Submitted for publication June 19, 1963; accepted
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“Since albumin does not cross the hemochorial placenta, as shown in the rat (60), guinea pig (61) and in vitro in a human placenta (62), it seems unlikely that the albumin fusion protein albiglutide should cross the placenta.”
From Effects of GLP-1 agonists and SGLT2 inhibitors during pregnancy and lactation on offspring outcomes: a systematic review of the evidence (2023) · cites this paper as [61]
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References 29 · Cited by 116
Research works printed but not linked: 12
- [1]1. Schenker, S., N. H. Dawber, and R. Schmid. Dis- position of bilirubin in the fetus (abstract). J. Lab. clin. Med. 1962, 60, 1015.
- [2]2. Fashena, G. J. Mechanism of hyperbilirubinemia in the newborn infant. Experimental demonstration of functional hepatic immaturity. Amer. J. Dis. Child. 1948, 76, 196.
- [3]3. Son Vahiquist, Bo C. Das Serumeisen. Eine Pidiatrisch-Klinische und Experimentelle Studie. Acta Paediat. (Uppsala) Suppl. V, 1941, 28, 172.
- [5]5. Brown, A. K., and H. S. McGaughey, Jr. Observa- tions on maternal, fetal and placental bilirubin concentrations at the time of delivery. Amer. J. Dis. Child. (abstract). 1960, 100, 574.
- [6]6. Brown, A. K., and W. Zuelzer. Studies on the neo- natal development of glucuronide conjugating sys- tem. J. clin. Invest. 1958, 37, 332.
- [7]7. Lathe, G. H., and M. Walker. An enzyme defect in human neonatal jaundice and in Gunn's strain of jaundiced rats (abstract). Biochem. J. 1957, 67, 9 P.
- [11]11. Cserna, S., and S. Liebman. Beitrag zur Lehre des Ikterus Neonatorum. Klin. Wschr. 1923, 2, 2122.
- [13]13. Doring, G. K. tber die Durchlassigkeit der Plazenta fur Bilirubin. Geburtsh. u. Frauenheilk. 1958, 18, 360.
- [19]19. Cohn, E. J., L. E. Strong, W. L. Hughes, Jr., D. J. Mulford, J. N. Ashworth, M. Melin, and M. L. Taylor. Preparation and properties of serum and plasma proteins. IV. A system for the separation into fractions of the protein and lipoprotein com- ponents of biological tissues and fluids. J. Amer. chem. Soc. 1946, 68, 459.
- [28]28. Brauer, R. W., L. M. Julian, and T. S. Krebs. Matu- ration of liver function in the chick embryo as explored with S35-sulfobromophthalein. Ann. N. Y. Acad. Sci. 1963, in press.
- [29]29. Schenker, S., J. Goldstein, and B. Combes. Un- published observations. 30. Grodsky, G. M. Aspects of the metabolism of bromsulfalein and bilirubin in Perinatal Pharmacol- ogy, Report of the 41st Ross Conference on Pedi- atric Research, C. D. May, Ed. Columbus, Ross Laboratories, 1962, p. 68.
- [31]31. Amoroso, E. C. Placentation in Marshall's Physiol- ogy of Reproduction, 3rd ed., A. S. Parkes, Ed. London, Longmans' Green, 1952, vol. 2, pp. 127-311.
Metadata
- Authors
- Schenker, S., Dawber, N. H., & Schmid, R.
- Affiliations
- Harvard University (US)
- Venue
- Journal of Clinical Investigation
- Published
- 1964-01-01
- Volume
- 43
- Issue
- 1
- Pages
- 32-39
- ISSN
- 0021-9738 (ISSN-L)
- PMC
- PMC289493
- OpenAlex
- W2036862728
- Cited by
- 116
- References
- 29
- Citations by year
- 2023: 1 · 2021: 1 · 2019: 1 · 2016: 1 · 2015: 1 · 2014: 1 · 2013: 2
- FWCI
- 25.80
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Investigation (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal Health and Biochemistry
- Health Sciences › Medicine › Surgery › Pediatric Hepatobiliary Diseases and Treatments
- Health Sciences › Medicine › Genetics (clinical) › Hemoglobinopathies and Related Disorders
- Keywords
- bilirubin metabolism, fetus, fetal erythropoiesis, cord blood bilirubin, hemolytic disease of the newborn, neonatal hyperbilirubinemia
- MeSH terms
- Animals, Bile, Bilirubin, Carbon Isotopes, Female, Fetus, Guinea Pigs, Humans, Iodine Isotopes, Liver, Maternal-Fetal Exchange, Metabolism, Pigments, Biological, Pregnancy, Pregnancy, Animal, Research, Serum Albumin
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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