Predictors of Neurodevelopmental Outcome in Hyperbilirubinemic Neonates Admitted in NICU

Author(s): M. A. Mannan, Md. Arif Hossain, Shimul Mandal, Sadeka Choudhury Moni, Ismat Jahan, Mohammad Kamrul Hassan Shabuj, Mohammod Shahidullah, Shaheen Akhter

Background: Neonatal hyperbilirubinemia is an important cause of preventable brain damage among infants. Neurodevelopmental assessment may help in the early identification and management of neurodevelopmental sequelae.

Objectives: The aim of this study were to identify the predictors of abnormal neurodevelopment at 3 & 12 months in babies having birth weight ≥1800 g and gestational age >34 weeks with neonatal hyperbilirubinemia.

Methods: This prospective observational study was conducted at Department of Neonatology and Institute of Pediatric Neurodisorder and Autism (IPNA), Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka, Bangladesh from July 2019 to June 2021. Hyperbilirubinemic newborns were followed up and their neurodevelopmental assessment was done by using BSID III method at 3 and 12 months of age. All the collected data was tabulated and statically analyzed by using SPSS software.

Results: A total of 90 newborns were enrolled, and among them 72 completed the first follow up and 67 completed second follow up. Average gestational age was 37.28±1.4 and mean birth weight was 2870.97 ± 458 g. There was slight female predominance 42 (58.3%) and 69 (95.8%) babies were inborn and only 3 (4.2%) were outborn. Out of 72 neonates, 9 (12.5%) had abnormal neurodevelopment results at 3 months, whereas 2 (3%) had neurodevelopmental abnormalities at 12 months. Neurodevelopmental follow up is suggesting reversibility of adverse neurodevelopment outcome. Perinatal and clinical data were compared between age appropriate neurodevelopment group and delayed neurodevelopment group. This study found that hemolytic jaundice, need for exchange transfusion, jaundice within first 24 hours, peak serum bilirubin > 20 mg/dl and longer duration of phototherapy > 48 hours were not significantly associated with abnormal neurodevelopment.

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