CORRELATION OF PEAK SERUM BILIRUBIN IN 1ST WEEK OF LIFE AND FUTURE NEURODEVELOPMENTAL OUTCOMES IN HEALTHY BABIES AT TERM

Abstract

Background: Neonatal jaundice is a common condition affecting the majority of infants without causing any damage to the brain. ABE (acute bilirubin encephalopathy) is seen with serum bilirubin levels exceed bilirubin binding capacity. Brain damage reversibility from ABE is a concern matter even after successful therapy.
Aim: The present study aimed to assess the correlation between peak serum bilirubin in 1st week of life and future neurodevelopmental outcomes in healthy babies at term. The study also assessed future neurodevelopmental outcomes in infants with extremely high serum bilirubin at 1st week of life.
Methods: The study assessed 104 near-term and term babies having features of ABE (acute bilirubin encephalopathy) having bilirubin levels>20mg/dl. These subjects were assessed at the 3rd and 6th month to assess their neurodevelopment. Neurological outcomes were assessed using BERA (brainstem evoked response audiometry) DDST-II (Denver Development Screening Test).
Results: The study results showed that the mean peak TSB (total serum bilirubin) was 25.1±2.33 mg/dl in the study subjects. In 23.5% (n=24) neonate subjects, abnormal development was seen and abnormalities were higher in babies where total serum bilirubin was more than 28mg/dl. BERA was abnormal in 13.7% of neonates.
Conclusions: The present study concludes that total serum bilirubin values <25mg/dl can be taken as the cut-off value for the reversibility of bilirubin-induced acute damage to the brain. The assessing clinicians should take appropriate consideration and not miss the chance for intervention. Also, poor outcome is associated in neonates with total serum bilirubin value of >28mg/dl and advanced stages of ABE as stages II and III are seen.