Manizheh Mostafa Gharehbaghi
*, Hanieh Faraji Azarfam, Robabeh Ghegherechi
1 Pediatric Health Research Center, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
Abstract
Background and Objectives: neonatal hyperbilirubinemia is a common problems during neonatal period that may be associated with neurodevelopmental later in life. There are several known risk factors for bilirubin encephalopathy, including total serum bilirubin levels and bilirubin albumin ratio. The aim of this study was to determine relationship between neurodevelopmental delay and total serum bilirubin and bilirubin albumin ratio. Materials and Methods: In a descriptive analytic method, 186 neonates who had serum bilirubin levels more than 18mg/dl and were treated with phototherapy or exchange transfusion were studied. Total serum bilirubin and bilirubin albumin ratio were determined and they were followed for one year and during this period Ages & Stages Questionnaires, ASQ score was determined in five neurodevelopment domains at their 4, 8 and 12 months of age. Results: One hundred sixty four neonates were treated with phototherapy and 22 with exchange transfusion. The mean bilirubin albumin ratio was 5 and 6.6 in phototherapy treated and exchange transfusion groups respectively (p=0.01) .ASQ score was less than cut off point in two domains in 5 (2.8%) of these patients. ASQ score in its communication domain at 8 months age was lower in patients with bilirubin-albumin ratio more than 7 [47.1±10.9 vs. 51.8±7.3 (p=0.03)]. In patients with total bilirubin greater than 25mg/dl the ASQ score in its communication domain was significantly lower than it in neonates with total bilirubin less than 25mg/dl (48.4±8 vs. 44.2 ±9.8 p=0.05). There was not significant relation between ASQ score in other domains at 4, 8 and 12 months ages of measurement and total serum bilirubin or bilirubin albumin ratio. Conclusion: The ASQ score in its communication domain was decreased at 8 mo in patients with higher bilirubin-albumin ratio and at 12 mo in patients with higher total serum bilirubin. It is recommended future studies to determine the relationship between neurodevelopment domains and total bilirubin and bilirubin-albumin ratio.