Research in Medicine

Background : Hyperbilirubinemia is a common and often benign problem in neonates.
Severe neonatal indirect hyperbilirubinemia associated with neurological developmental disabilities, including auditory, cognitive and motor disorders. Motor disorders include dystonia, athetosis that is consistent with lesions of core nuclei. The tone and coordination abnomality are signs of lesion in cerebellum. Hyperbilirubinemia and kertnicterus-induced hearing loss include hearing processing imparment and sensorineural hearing loss. The goal of this study was to determine the neurological developmental  outcome and kernicterus in children at ages 24-36 months who had severe neonatal hyperbilirubinemia.
Materials and Methods: In a longitudinal study, newborns  that admitted to hospital with severe neonatal indirect  hyperbilirubinemia were followed. In one year, 181 neonates were admited and treated for severe jaundice. At the age 24 to 36 months, 121 cases were followed and evaluated for kernicterus.
Results: In this study 121 patients were followed that 52 patients (43%) were girls and 69 (57%)  were boys. The age of newborns at admission was 4.14±1.27 days and their birth weight was 3102 ±559 grams. The mean values of billirubin was 21.29±4.21 mg/dl at the time of hospitalization. Twenty eight patients (19.83%) had underwent exchange transfusion in addition to intensive phototherapy, of which 8 neonates(6.61%) had evidence of ABO incompatibiliry. These 8 patients had received intravenous immunglobolin to prevent the need for second exchange transfusion. Among the followed patients,  3 infants (2.47%) had developmental delay and diagnosed as kernicterus, of which 2 neonates had exchange transfusion due to ABO incompatibility.
Conclusion: In this study, less than 3% of infants with severe neonatal hyperbilirubinemia developed  kernicterus. It is necessary to inform parents about neonatal jaundice and its complications. Severe jaundice should be taken serious in the first days of life because of risk for kernicterus. Severe neonatal hyperbilirubinemia, if not treated properly and quickly, can cause developmental delay.