Outcome of Neonatal Hyperbilirubinemia And Its Effect on Neurological System In Full term and Preterm Baby

Assar, Effat Hussein; El Ghaiaty, Hesham; Mohamed, Nouran Nasef; Ali, Ahmed Shaheen

doi:10.21608/bmfj.2023.171262.1695

Outcome of Neonatal Hyperbilirubinemia And Its Effect on Neurological System In Full term and Preterm Baby

Document Type : Original Article

Authors

¹ Pediatric department;faculty of medicine;Benha University;Qalyubia

² paediatrics department, faculty of medicine, benha university

³ Department of Pediatrics Faculty of Medicine, Benha University

⁴ Department of pediatrics faculty of medicine, benha university

10.21608/bmfj.2023.171262.1695

Abstract

Background: Bilirubin-induced neurologic dysfunction (BIND) is the term applied to the spectrum of neurologic abnormalities associated with hyperbilirubinemia. This study aimed to study the outcome of neonatal hyperbilirubinemia and its effect on neurological system in full term and preterm baby. Methods: This cross sectional study was conducted on 112 cases indirect hyperbilirubinemia (75 full term and 37 preterm). All studied cases were subjected to full history taking; complete clinical assessment, and laboratory investigations, Modified bilirubin-induced neurological dysfunction (BIND) score. Follow up was done at 3 months by detailed neurological assessment. Results: Preterm group had a statistically higher frequency of adverse outcome (62.2%) compared to full term group (25.3%), p < 0.001. Mortality rate was statistically higher in preterm group (32.4%) compared to full term group (5.3%). Moreover, abnormal neurological assessment was statistically higher in preterm group (29.7%) compared to full term group (20%), p=0.022. Neonates with adverse outcome had statistically higher BIND scores (7.5±1.3) compared to neonates with normal outcome (4.2±1.6), p < 0.001. Bind score correlates positively with total bilirubin, and correlates negatively with weight and Apgar score. ROC analysis was done to assess the performance of BIND score to predict adverse outcome in the studied neonates; At a cutoff point > 5 , the sensitivity was 90.5% and specificity was 77.1%. Conclusion: BIND score can predict adverse outcomes in infants with neonatal hyperbilirubinemia, which would be more useful for the clinicians to take a more prompt and aggressive intervention on those with a high risk of adverse outcomes.

Keywords