Predictors of Neurodevelopmental Outcome in Hyperbilirubinemic Neonates Admitted in NICU

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 J Pediatr Perinatol Child Health 2022; 6 (2): 200-218 DOI: 10.26502/jppch.74050102 Journal of Pediatrics, Perinatology and Child Health 201 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. Hyper-bilirubinemic 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. Conclusion: 9 (12.5%) and 2 (3%) had abnormal neurodevelopment at 3 months and at 12 months respectively who were treated for neonatal jaundice suggesting reversibility of adverse neurodevelopment outcome. None of the factors (eg. hemolytic neonatal jaundice, onset of jaundice within 24 hours of age, peak serum bilirubin levels >20mg/dl, need for exchange transfusion and duration of phototherapy >48 hours were significantly not associated with adverse neurodevelopmental outcomes in infants born at or near term.