Correlation between hyperbilirubinemia in term infants and developmental delay in 2-4 year-old children

  • Rocky Wilar Department of Child Health, Sam Ratulangi Univetsity Medical School/Prof. Dr. R. D. Kandou Hospital, Manado
  • Nurhayati Masloman Department of Child Health, Sam Ratulangi Univetsity Medical School/Prof. Dr. R. D. Kandou Hospital, Manado
  • Hesti Lestari Department of Child Health, Sam Ratulangi Univetsity Medical School/Prof. Dr. R. D. Kandou Hospital, Manado
  • William Stephenson Tjeng Department of Child Health, Sam Ratulangi Univetsity Medical School/Prof. Dr. R. D. Kandou Hospital, Manado
Keywords: term infant, hyperbilirubinemia, developmental delayed

Abstract

Background Up to 50 percent of term newborns have clinical jaundice during the first week of life. Many infants with bilirubin encephalopathy were asymptomatic, but they show neurodevelopmental delay few years later. Toxic effect occurs if unbound unconjugated bilirubin penetrates blood brain barrier and causes neuronal death.

Objective To investigate the relationship between moderate hyperbilirubinemia in tenn infants and developmental delay in 2- 4 year-old children.

Methods A retrospective cohort study was performed using
medical record of infants born between 2006-2007 in Division of Neonatology Prof. R.D. Kandoll General Hospital, Manado. Data from the medical record consisted of weeks of gestation, birth weight, Apgar scores, diagnosis of sepsis, congenital anomalies. Tenn infants with appropriate weight for gestational age were visited at their home to undergo developmental screening by Denver II and Vineland Social Maturity Scale test.

Results Fifty one children enrolled in this study (26 children with hyperbilirubinemia and 25 without  hyperbilirubinemia) consisted of 27 boys and 24 girls. Most children were 24 - 29 months old (24/51). The results of Vineland Social Maturity Scale test showed 14 children had delayed social maturation (10 Mth history of  hyperbilirubinemia). Denver II screening found 11 children had delayed language skill (10 Mth history of hyperbilirubinemia), 1 child Mth hyperbilirubinemia had delayed fine motoric and language skill.

Conclusions T here is a relationship between moderate hyperbilirubinemia in tenn infants and developmental delay in 2 - 4 year old children.

References

1. Wong RJ, Stevenson DK, Ahlfors CE, Vreman HJ. Neonatal
jaundice: bilirubin physiology and clinical chemistry. Neonatol Rev. 2007;6.58-65.
2. Porter LM, Dennis BL. Hyperbilirubinemia in the term newborn. Am Fam Physician. 2002;65:599-606.
3. Colletti EJ, Kothori S, Jackson MD, Kilgore PK, Barringer K. An emergency medicine approach to neonatal hyperbilirubinemia. Emerg Med Clin N Am. 2007;25:1117-35.
4. Bhutani VK, Johnson L. Kernicterus: a preventable neonatal brain injury. J Arab Neonatal Forum. 2005;2:12-24.
5. De Bor MV, Van Zeben T M, VanHorick PY, Brand R, Ruys JH. Hyperbilirubinemia in preterm infants and neurodevelopmental outcome at 2 years of age: results of a national collaborative survey. Pediatrics. 1989;83:915-20.
6. Arimbawa 1M, Soetjiningsih, Kari IK. Adverse effects of hyperbilirubinemia on the development of healthy teen infants. Paediatr Indones. 2006;47:51-56.
7. Sooroni-Lunsing I, WoltH HA, Hadders􀁡Algra M. Are moderate degree of hyperbilirubinemia really safe for the brain? Pediatr Res. 2001;50:701-5.
8. Connolly AM, Volve J]. Clinical features of bilirubin encephalopathy. Clin Perinatol. 1990; 17:371-9.
9. Reyes AL. Concept of developmental screening, assestment and surveillance. Proceeding at National Seminar: An overview of children behaviour and development, 2001 J ul 19-21, Bandung, Indonesia.
10. Irwanto, Suryawan A, Narendra MB. Penyimpangan tumbuh kembang anak. Kapita selekta ilmu kesehatan anak VI. Surabaya: Divisi Tumbuh Kembang Anak Dan Remaja Bagian Hmu Kesehatan Anak FK Unair RSU Dr. Soetomo, 2006; p. 1-12.
11. Perinatal asphyxia. In: Gomella LG, Cunningham MD, Eyal FG, Zenk KE, editors. Neonatology, management, procedures, on􀁡call problems, diseases, and drugs. 5th ed·. New York . McGraw-Hill, 2007; p. 512-23.
12. Saharso D, Hidayati SN. Infeksi susunan saraf pusat. In: Soetomenggolo TS, Ismael S, editors. Buku ajar neurologi anak. Jakarta. BP IDAI, 1999; p. 339-85.
13. Sukadi A. Hiperbilirubinemia. In: Kosim MS, Yunanto A, Dewi R, Sarosa GI, Usman A, editors. Buku ajar neonatologi. 1 st ed. Jakarta. Badan Penerhit IDA!, 2008; p. 147-69.
14. Glascoe FP, Byrne KE, Ashford LG, Johnson KL, Chang B, Strickland B. Accuracy of the Denver II in developmental screening. Pediatrics. 1999;89:1221-5.
15. Soetjiningsih. Tumbuh - kembang anak. In: Soetjiningsih, Ranuh IGN, editors. Tumbuh kembang anak. 1 st ed. Jakarta:
EGC, 1995; p. 63-94.
16. World Health Organization. WHO child growth standards. Geneva, Switzerland: WHO Press; 2006
17. Raspati H, Reniarti L, Susanah S. Anemia defisiensi besi. In: Permana HB, Sutaryo, Ugrasena IDG, Windiastuti E, Abdulsalam M, editors. Buku ajar hematologi􀁡onkologi anak. 1 sted. Jakarta : Badan Penerbit IDAI, 2005; p. 30A3.
18. Onnert E, Erdem G, Topcu M, Yurdakok M, Genc D, et al. Long tenn follow􀁡up of unconjungated hyperbilirubinemia in full tenn Turkish infants. Acta Pediatr. 1996;85:1440A.
29. Yilmaz Y, Kradeniz L, Yildiz F, Degirmenci SY, Say A. Neurological prognosis in tenn newborns with neonatal indirect hyperbilirubinemia. Indian Pediatr. 2001;38:165-8.
20. Nilsen St, Finne PH, Bergso P, Stammes o. Males with neonatal hyperbilirubinemia examined at 18 years of age. Acta Pediatr Scand. 1994;73.176-80.
21. Onnert E, Erdem G, Topcu M, Yurdakok M, Genc D. Long term follow-up of unconjungated hyperbilirubinemia in full term Turkish infants. Acta Pediatr. 1996;85:1440A.
22. Cashore WJ. The neurotoxicity of bilirubin. Clin Perinatol. 1990;17;437-47.
23. Maissel MJ. Jaundice. In: Macdonald MG, Seshia MM, Mullet MD, editors. Avery's neonatology pathophysiology and management of the newborn. 6th ed. Philadelphia: Lippincott William and Wilkins, 2005; p. 1532-70.
24. Needleman RD. Growth and development. In: Behnnan RE, Kliegman RM, Jenson HB, editors. Nelson textbook of pediatrics. 17th ed. Philadelphia: WB. Saunders Company, 2004; p. 23-57.
25. Frakenburg WK, Dodds J, Archer p, Shapiro H, Bresnick B. T he Denver II: a major revision and restandardization of the Denver developmental screening test. Pediatrics. 1992;89.91-7.
26. Amin Sanjiv B. Priming D, Myers G. Hyperbilirubinemia and language delay in premature infants. Pediatrics. 2009; 123.327-31.
27. Soetjiningsih. Tumbuh - kembang anak. In: Soetjiningsih, Ranuh IGN, editors. Tumbuh kembanganak.1st ed.Jakarta: EGC, 1995; p.63-94.
Published
2010-06-30
How to Cite
1.
Wilar R, Masloman N, Lestari H, Tjeng W. Correlation between hyperbilirubinemia in term infants and developmental delay in 2-4 year-old children. PI [Internet]. 30Jun.2010 [cited 22Nov.2024];50(3):154-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/813
Section
Articles
Received 2016-10-06
Accepted 2016-10-06
Published 2010-06-30