Long-term follow-up of otherwise healthy term infants with marked hyperbilirubinaemia: should the limits of exchange transfusion be changed in Turkey?

Duman, Nuray; Özkan, Hasan; Serbetcioglu, Bulent; Öğün, B.; Kumral, Abdullah; Avci, Melek

doi:10.1080/08035250310007475

Cited by 6 publications

(2 citation statements)

References 29 publications

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“…In another study conducted with the similar patient group, any correlation between sTB levels and ABR latencies, was not detected. None of the infants had hearing loss, developmental delay or neurological dysfunction 21 . On the other hand, some other studies reported a positive correlation between bilirubin levels and ABR results 22 - 24 .…”

Section: Discussionmentioning

confidence: 97%

Long-term Effects of Indirect Hyperbilirubinemia on Auditory and Neurological Functions in Term Newborns

Besli¹,

Metin²,

Aksit³

et al. 2020

MMJ

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Objective:The aim of this study was to investigate the long-term effects of hyperbilirubinemia on neurological and hearing function in otherwise healthy term newborns with neonatal indirect hyperbilirubinemia. Method: This study was performed prospectively in 41 term newborns hospitalized for indirect hyperbilirubinemia. Patients with no signs of hemolysis were categorized in 3 groups based on stabil levels as sTB <20 mg/dl, 20-24.9 mg/dl, and =>25 mg/dl. Patients with total bilirubin level =>20 mg/dl and hemolytic disease were classified as the fourth group. The relationship between maximum sTB level, duration of exposure to sTB levels >20 mg/dl and etiology of jaundice with neurological and auditory functions was investigated. Detailed neurological examination, Denver II developmental screening test and hearing tests (otoacoustic emissions, OAE and auditory brainstem responses, ABR) were performed to all patients between 18-24 months of age. Results: Neurodevelopmental disorder was found in 5 (12.2%) patients. Hemolytic disease was detected in two of these patients. Hearing loss was found in 4 (9.8%) of the patients. Two of these patients had auditory neuropathy spectrum disorder and the other two had cochlear hearing loss. The sTB levels of all these patients were above 25 mg/dl. No neurological disorder or hearing loss was found in the patients who had stabil of <25 mg/dl. Exposure time to sTB levels above 20 mg/dl was significantly longer in patients with neurological dysfunction and pathologic ABR results (p:0.007, p:0.007; p<0.05). Conclusion:This study demonstrates that kernicterus may develop in term newborns with severe hyperbilirubinemia (sTB>25 mg/dl) without any finding of significant hemolysis. Not only the bilirubin level but also the duration of exposure to high bilirubin levels may be effective in the development of bilirubin neurotoxicity. The high rate of hearing loss in our patients emphasizes the importance of screening for infants with severe hyperbilirubinemia using comprehensive auditory evaluation for early diagnosis of possible hearing loss. ÖZAmaç: Bu çalışmada, neonatal indirekt hiperbilirubinemi dışında başka sorunu olmayan term yenidoğanlarda, hiperbilirubineminin nörolojik gelişim ve işitme fonksiyonu üzerinde uzun dönem etkilerinin araştırılması amaçlanmıştır. Yöntem: Bu çalışma, indirekt hiperbilirubinemi nedeniyle yatırılarak tedavi edilen 41 term yenidoğanda ileriye dönük olarak gerçekleştirilmiştir. Hemoliz bulgusu saptanmayan hastalar sTB <20 mg/dl, 20-24.9 mg/dl, =>25 mg/dl olarak 3 gruba ayrılmıştır. Hemolitik hastalık saptanan ve sTB =>20 mg/dl olan hastalar 4. grup olarak belirlenmiştir. Maksimum sTB düzeyi, sTB >20 mg/dl üzerinde kalma süresi ve sarılık etyolojisi ile nörolojik ve işitsel fonksiyonlar arasındaki ilişki incelenmiştir. Tüm olgulara 18-24. aylar arasında ayrıntılı nörolojik muayene, Denver II gelişimsel tarama testi ve işitme testleri (otoakustik emisyon, OAE ve işitsel beyin sapı cevapları, ABR) incelemesi yapılmıştır. Bulgular: Hastaların 5'inde (%12,2) nö...

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Section: Discussionmentioning

confidence: 97%

Long-term Effects of Indirect Hyperbilirubinemia on Auditory and Neurological Functions in Term Newborns

Besli¹,

Metin²,

Aksit³

et al. 2020

MMJ

View full text Add to dashboard Cite

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“…Duman N et al [18] thought that newborns had better tolerance to bilirubin neurotoxicity without the suggested risk factors, therefore, they proposed to modify the existing ECT guidelines by properly enhancing the bilirubin threshold. After Ding Guofang et al [19] studied 875 normal one-month newborns, it was discovered that TSB levels were different in the neonates born in different regions and seasons.…”

Section: Discussionmentioning

confidence: 99%

Report about term infants with severe hyperbilirubinemia undergoing exchange transfusion in Southwestern China during an 11-year period, from 2001 to 2011

Hui-fan

Zhang

et al. 2017

PLoS ONE

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ObjectivesThis study was intended to explore the etiology and risk factors of severe neonatal hyperbilirubinemia and to analyze the adverse events associated with ECT (Exchange Transfusion), as well as to identify the factors related to the poor prognosis.MethodsAll of the full-term neonates who had undergone ECT for hyperbilirubinemia at Children’s Hospital of Chongqing Medical University from January 2001 to December 2011 were enrolled in this study. General demographic characteristics, comorbidities, pre- and post-exchange TSB(Total Serum Bilirubin) levels, duration and frequency of ECT, and clinical outcomes were recorded and analyzed anonymously.ResultsOf 614 total infants, 368 patients (59.9%) with ABO incompatibility were identified, of whom 197 (53.5%) developed acute bilirubin encephalopathy (ABE) and 16 (4.3%) suffered a poor prognosis. The etiology was unidentified in 103 patients (16.8%), of whom 62 (60.1%) developed ABE and 9 (8.7%) had a poor prognosis. Identified adverse events secondary to ECT included thrombocytopenia (54.6%), hyperglycemia (42.8%), apnea (3.3%) and necrotizing enterocolitis (NEC) (1.3%). No ECT-related mortality was documented in this study.ConclusionsThe etiology, peak TSB level before ECT, and time of ECT had a significant impact on the outcome of severe neonatal hyperbilirubinemia. ABO incompatibility was the most common cause of extreme neonatal hyperbilirubinemia. Pathological weight loss could be involved in the development of extreme hyperbilirubinemia with an unidentified cause.

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Neonatal jaundice: in the eye of the beholder?

Manning

2009

Archives of Disease in Childhood - Fetal and Neonatal Edition

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Long-term follow-up of otherwise healthy term infants with marked hyperbilirubinaemia: should the limits of exchange transfusion be changed in Turkey?

Cited by 6 publications

References 29 publications

Long-term Effects of Indirect Hyperbilirubinemia on Auditory and Neurological Functions in Term Newborns

Long-term Effects of Indirect Hyperbilirubinemia on Auditory and Neurological Functions in Term Newborns

Report about term infants with severe hyperbilirubinemia undergoing exchange transfusion in Southwestern China during an 11-year period, from 2001 to 2011

Neonatal jaundice: in the eye of the beholder?

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