Long-Term Neurodevelopmental Outcomes of Newborns with High Bilirubin Levels

INTRODUCTION: The aim of this study is to evaluate the long-term neurodevelopmental outcomes of newborns who had exchange transfusion due to hyperbilirubinemia and presented with bilirubin values at the border of exchange transfusion and did not need exchange transfusion during the preparation period.
METHODS: The study included 18 patients (n=18) who had exchange transfusion due to indirect hyperbilirubinemia (Group 1) and 10 patients (n=10) who applied with a bilirubin value at the border of exchange transfusion and decreased bilirubin during the preparation period (Group 2). Neurological examination, cranial magnetic resonance imaging (MRI), and auditory brainstem response test (BERA) results of the cases were evaluated through cross-sectional analysis. Ankara Developmental Inventory for children under the age of six and Wechsler intelligence scale-Revised for children over the age of six were performed.
RESULTS: Sixty-seven percentage (n=12) of the patients in Group 1 were male, mean gestational week was 38.4±1.8 (34–42) and mean age was 8.8±2.1 years. 40% (n=4) of the patients in Group 2 were male, mean gestational week was 37.9±1.7 (36–40) and mean age was 8.2±2.2 years.The mean venous serum total bilirubin level of group 1 was 29.5±8.2 mg/dL and Group 2 was 22.8±3.9 mg/dL, which was statistically significant (p=0.024). Neurological examination was abnormal in four patients in Group 1 and one patient in Group 2. Two of the cranial MRIs (n=8) in Group 2 were pathological. There was no significant difference between the groups in terms of neurological examination, cranial MRI, BERA, and developmental tests.
DISCUSSION AND CONCLUSION: In this study, the fact that there was no neurodevelopmental difference between the cases who underwent exchange transfusion or whose bilirubin levels were lowered by phototherapy without the need for exchange transfusion, and the cases with neurodevelopmental abnormalities were very few, once again demonstrated the importance of intervening before bilirubin encephalopathy occurs.