Abstract

Aim: Neonatal indirect hyperbilirubinemia is a disorder that may be associated with loiıg term neuromotor maldevelopment. The aim of the study is to evaluate the effect of severe indirect hyperbilirubinemia on neurodevelopmental outcome. Methods: The study included 55 children as a Study Group with a history of neonatal jaundice. Inclusion criteria were indirect hyperbilirubinemia, term birth and absence of risk factors for hyperbilirubinemia such as hemolysis, asphyxia and infection. The Control Group included 32 children with a history of term birth and normal neonatal period. Both groups were evaluated with a neurological examination and by Denver Developmental Screening Test (DDST), ata median age of 22 months and 3 months later. Results: DDST were found ARNORMAL in 7 (12. 7%) patients within the study group, whereas, it was NORMAL in all of the healthy controls (p=0.04). There was no statistical. Difference between the patients with normal and abnormal DDTS, when compared in terms of gestational age, birth weight, gender, admission age, time of hospitalization and number of patients gone through exchange transfusion. However, a statistical difference was found between the two groups in terms of the indirect bilirubin levels at the admission, 22.1 ± 3.7 mg,Hf and 29.2 ± 6.8 mgldl, respectively (p=O.OOO). Patients with serumindirect bilirubin levels <2: 22 mg/dl and <22 mg/dl alsa revealed a statistical difference in terms of abnormal DDTS (p=0.03). Conclusion: We conclude that despite efficient treatment modalities, severe neonatal indirect hyperbilirubinemia results in worsening of Jang term neurodevelopmental outcome and that serum indirect bilirubin levels 2: 22 mg/dl can be considered a risk factor for bilirubin neurotoxicity in otherwise healthy term newborns.