The Development of Conjugation Mechanisms and Drug Toxicity in the Newborn

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Abstract
The enzymatic detoxifying processes of the liver in the newborn show differences from those seen in later life. Glucuronyl-transferase which catalyzes the formation of glucuronides is not very active at birth, hence the slow excretion of glucuronide substances (e.g., bilirubin, steroids, acetanilids, phenacetin and chloramphenicol) leads to an accumulation of these compounds and their metabolites which can produce toxic reactions in the neonatal period. Furthermore, the main conjugates of p-aminobenzoic acid in urine and plasma of the newborn are acetylated, but p-aminobenzoic acid (= p-acetamidobenzoic acid) and acetylated p-aminohippuric acid form more slowly in the newborn than in older individuals in whom p-aminobenzoic acid is excreted chiefly as a glycine conjugate (p-aminohippurate).