A study of predictors & prevalence of neurodevelopmental outcome in hyper-bilirubinemic neonates admitted in NICU

Abstract

Background: Hyper-bilirubinemia may be toxic to the developing central nervous system and may cause neurological impairment. This study was conducted to identify factors of abnormal neurodevelopment at 3 & 12 months in babies having birth weight >1.5 kg and gestational age >34 weeks with neonatal hyper-bilirubinemia. Methods: This prospective study was conducted at Sardar Patel Medical College, Bikaner (Rajasthan) from 2014 to 2015. Hyper-bilirubinemic newborns were examined at 3 and 12 month age and their neurodevelopmental assessment was done by DASII method. All the collected data was tabulated and statically analyzed by using SPSS software. Results: 69.79% of hyper-bilirubinemic neonates were males & 30.21% were females. The prevalence of neurodevelopmental abnormalities (DQ≤70) was 10.42% at 3 months where as it was 6.25% at 12 months follow up suggesting reversibility of adverse neurodevelopment. Early onset of jaundice (≤1 day), serum bilirubin level >25 mg/dl, duration of hospital stay>3 days and requirement of exchange transfusion was significantly associated with adverse neurodevelopmental outcomes (DQ≤70) at 3 and 12 months of age on follow up. Conclusion: This Prospective observational study found a high prevalence of adverse neurodevelopmental outcome in neonates with hyper-bilirubinemia with risk factors. Early detection of neurodevelopmental abnormalities and initiation of early intervention measures to reduce the prevalence of neurodevelopmental abnormalities in hyper-bilirubinemic neonates.