DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20184276

Clinicoetiological profile, immediate outcome and short-term follow-up of term babies with hyperbilirubinemia

Sonika C., Manoj D., Basanth Kumar G. R.

Abstract


Background: Neonatal jaundice is a common cause of admission of newborns. Since bilirubin is potentially toxic to the central nervous system, early detection and appropriate management is of paramount importance. We therefore undertook this study with an objective to assess the causes, clinical correlation, immediate outcome and short term follow up for hearing and neurodevelopmental assessment in term babies with jaundice admitted in our NICU.

Methods: This study was done in NICU in Bapuji Child Health Institute and Research center attached to JJMMC, Davangere. This study included 100 term infants admitted for jaundice during November 2013 to May 2015 and 6 months follow up of these infants for hearing and neurodevelopmental outcome was done. A proforma was used to collect relevant information.

Results: Physiological jaundice (50%) and Blood group incompatibility (36%) were the most common causes of hyperbilirubinemia in the study. During a short term follow up i.e. 6 months, majority (97%) of the jaundiced infants had normal hearing and neurodevelopmental outcome except for 3 infants who had sensorineural hearing loss and BIND. In severe group the percentage of abnormal BERA and unfavourable neurological outcome was more when compared to moderate group, which was statistically significant. All the 3 infants who had abnormal BERA had developmental delay.

Conclusions: Neonatal jaundice is a common cause of admission of newborns. Physiological jaundice was the commonest cause of neonatal hyperbilirubinaemia followed by blood group incompatability. Majority of the infants had normal BERA and normal neurodevelopmental outcome on short term follow up. A close association was found between BERA and neurodevelopmental outcome in the study. BERA is an useful neurophysiological tool for monitoring neurological complications, however it is not a useful tool to predict final neurological outcome


Keywords


BERA, Hyperbilirubinemia, Neurodevelopmental outcome, Term neonates

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References


American Academy of Pediatrics, Subcommittee on Hperbilirubinemia. Management of Hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatr. 2004;114:297-316.

Guruprasad G. Management of neonatal hyperbilirubinemia. NNF Clinical Practice Guidelines; 2010:139-52.

Gupta AK, Raj H, Anand NK. Auditory brainstem responses (ABR) in neonates with hyperbilirubinemia. Indian J Pediatr. 1990;57:705-11.

Sabatino G, Verrotti A, Ramenghi LA. Newborns with hyperbilirubinemia: usefulness of brainstem auditory response evaluation. Neurophysiol Clin. 1996;26:363-8.

Wong V, Chen WX, Wong KY. Short- and long-term outcome of severe neonatal Non-hemolytic hyperbilirubinemia. J Child Neurol. 2006;21:309-15.

Agrawal VK, Shukla R, Misra PK. Brainstem auditory evoked response in newborns with hyperbilirubinemia. Indian Pediatr. 1998;35:513-8.

Sharma P, Chhangani NP, Meena KR. Brainstem evoked response audiometry (BAER) in neonates with hyperbilirubinemia. Indian J Pediatr. 2006;73:413-6.

Gupta AK, Mann SB. Is auditory brainstem response a bilirubin neurotoxicity maker? Am J Otolaryngol. 1998;19:232-6.

Rhee CK, Park HM, Jang YJ. Audiologic evaluation of neonates with severe hyperbilirubinemia using transiently evoked otoacoustic emissions and auditory brainstem responses. Laryngoscope. 1999;109:2005-2008

Funato M, Teraoka S, Tamai H. Follow-up study of auditory brainstem responses in hyperbilirubninemic newborns treated with exchange transfusion. Acta Paediatr Jpn. 1996;38:17-21.

Yilmaz Y, Degirmenci S, Akdas F. Prognostic value of auditory brainstem response for neurologic outcome in patients with neonatal indirect hyperbilirubinemia. J Child Neurol 2001;16:772-5.

Katona G, Farkas Z, Revai K. Follow-up studies of patients with neonatal icterus using acoustic evoked potential audiometry. Orv Hetil. 1989;130:1001-4.

Pallotta R, Minervino M, Sabatino G, Nardini P. Long-term effects of neonatal medium-degree hyperbilirubinemia on brainstem evoked potentials. Pediatr Med Chir. 1984;6:273-5.

Hosono S, Ohno T, Kimoto H. Follow-up study of auditory brainstem responses in infants with high unbound bilirubin levels treated with albumin infusion therapy. Pediatr Int. 2002;44:488-92.

Chen WX, Wong V, Wong KY. Neurodevelopmental outcome of severe neonatal hemolytic hyperbilirubinemia. J Child Neurol. 2006;21:474-9.

Thoma J, Gerull G, Mrowinski D. A long-term study of hearing in children following neonatal hyperbilirubinemia. Arch Otorhinolaryngol. 1986;243:133-7.

Ogun B, Serbetcioglu B, Duman N. Long-term outcome of neonatal hyper-bilirubinaemia: subjective and objective audiological measures. Clin Otolaryngol Allied Sci. 2003;28:507-13.

Ozmert E, Eedem G, Topcu M. Long-term follow-up of indirect hyperbilirubinemia in full-term Turkish infants. Acta Paediatr. 1996;85:1440-4.