Adverse effects of hyperbilirubinemia on the development of healthy term infants
Keywords:
healthy term infants, hyperbilirubinemia, gross motor scale delay, Mullen Test
Abstract
Background Indirect hyperbilirubinemia is a common problem dur-ing the neonatal period and may cause long-term abnormality or
developmental delay.
Objective To evaluate the adverse effects of hyperbilirubinemia
on the development of healthy term infants.
Methods This was a prospective cohort study on healthy term
infants born in Sanglah Hospital, Denpasar. Mullen Scale Tests
were performed at the ages of 3 and 6 months to assess subjects’
development. Bivariate and multivariate analyses were conducted
to examine the relationship between several dependent variables
and developmental outcomes.
Results One hundred and twelve infants were enrolled in this study
[56 with hyperbilirubinemia, 56 without hyperbilirubinemia; 58 (52%)
male, 54 (48%) female]. Mean birth weight was 318.3 grams (SD
342.26) vs 3162.5 grams (SD 338.61). At the age of 3 months,
below average category according to Mullen Scale Test was higher
in infants with history of hyperbilirubinemia compared to those with-
out hyperbilirubinemia, which was statistically significant for fine
motor scale (17.9% vs 5.4%; respectively; P=0.039; RR 1.66; 95%
CI 1.15;2.39). At 6 months of age, it was higher in infants with
history of hyperbilirubinemia compared to those without hyperbi-
lirubinemia and this was statistically significant for gross motor scale
(19.6% vs 3.6%, respectively; RR 1.86; 95%CI 1.36; 2.56; P=0.008)
and fine motor scale (17.9% vs 5.4%, respectively; RR 1.66; 95%CI
1.15; 2.39; P=0.039). Multivariate logistic regression test showed
that only hyperbilirubinemia was correlated with gross motor scale
delay at the age of 6 months (P=0.027; OR 5.97; 95%CI 1.22;
29.12).
Conclusion Healthy term infants with history of hiperbilirubinemia
were associated with increased gross motor scale delay at the
age of 6 months
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damage the brain of healthy full-term infants? Clin
Perinatol 1990;17:331-58.
Neurological prognosis in term newborns with neona-
tal indirect hyperbilirubinemia. Indian Pediatr
2001;38:165-8.
2. NewmanTB, Klebanoff MA. Neonatal hyperbilirubine-
mia and long-term outcome: Another look at the col-
laborative perinatal project. Pediatrics 1993;92:651-7.
3. Ip S, Chung M, Kulig J, O’Brien R, Sege R, Glicken S,
et al. An evidence-based review of important issues
concerning neonatal hyperbilirubinemia. Pediatrics
2004;114:130-53.
4. Connolly AM, Volve JJ. Clinical features of bilirubin
encephalopathy. Clin Perinatol 1990;17:371-9.
5. Volpe JJ. Bilirubin and brain injury. In Volpe JJ, editor.
Neurology of the newborn. 4th ed. Philadelphia: WB
Saunders; 2001. p. 521-46.
6. Monintja HE. Sikap rasional terhadap ikterus neona-
torum non obstruktif. In: Yu VYH, Monintja HE, edi-
tors. Beberapa masalah perawatan intensif neonatus.
Jakarta: BP FK UI; 1997. p. 231-43.
7. Stoll BJ, Kliegman RM. Digestive system disorders. In:
Behrman RE, Kliegman RM, Jenson HB, editors.
Nelson’s texbook of pediatrics. 17th ed. Philadelphia:
WB Saunders; 2004. p. 592-9.
8. Cashore WJ. The neurotoxicity of bilirubin. Clin
Perinatol 1990;17:437-47.
9. Bratlid D. How bilirubin gets into the brain. Clin
Perinatol 1990;17:449-65.
10. Soorani-Lunsing I, Woltil HA, Hadders-Algra M. Are
moderate degrees of hyperbilirubinemia in healthy term
neonates really safe for the brain? Pediatr Res
2001;50:701-5.
11. Soetjiningsih. Upaya peningkatan kualitas tumbuh
kembang anak. In: Ranuh IGN, editor. Tumbuh
kembang anak. Jakarta: EGC; 1995. p. 127-40.
12. Needlman RD. Growth and development. In: Behrman
RE, Kliegman RM, Jenson HB, editors. Nelson’s
texbook of pediatrics. 17th ed. Philadelphia: WB
Saunders; 2004. p. 30-44.
13. Mullen EM. General administration and scoring pro-
cedures. In: Mullen EM, editor. Mullen scales of early
learning [manual]. AGS ed. United States of America:
American Guidance Service; 1995. p. 19-31.
14. Soetjiningsih. Tumbuh kembang anak. In: Ranuh IGN,
editor. Tumbuh kembang anak. Jakarta: EGC; 1995.
p. 1-36.
15. Moersintowati. Deteksi dini gangguan tumbuh
kembang anak. Proceedings of the Symposium on the
Latest Advances in Child Health in Achieving Opti-
mal Growth and Development (Simposium
Penatalaksanaan Mutakhir Bidang Ilmu Kesehatan Anak
untuk mencapai Tumbuh Kembang Optimal); 2000 Juli
21-22; Bandung, Indonesia.
16. Mullen EM. Theoretical framework and description of
the scales. In: Mullen EM, editors. Mullen scales of
early learning [manual]. AGS ed. United States of
America: American Guidance Service; 1995. p. 2-12.
17. Dennery PA, Seidman DS, Stevenson DK. Neonatal
hyperbilirubinemia. N Engl J Med 2001;344:581-90.
18. McMahon JR, Stevenson DK, Oski FA. Bilirubin tox-
icity, encephalopathy, and kernicterus. In: Taeusch CH,
Ballard RA, editors. Avery’s diseases of newborn. 7th
ed. Philadelphia: W.B Saunders; 1998. p. 1008-13.
19. Newman TB, Maisels MJ. Does hyperbilirubinemia
damage the brain of healthy full-term infants? Clin
Perinatol 1990;17:331-58.
Published
2016-10-18
How to Cite
1.
Arimbawa I, Soetjiningsih S, Kari I. Adverse effects of hyperbilirubinemia on the development of healthy term infants. PI [Internet]. 18Oct.2016 [cited 27Apr.2024];46(2):51-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/901
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Received 2016-10-13
Accepted 2016-10-13
Published 2016-10-18
Accepted 2016-10-13
Published 2016-10-18
