1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-3-47-b 10.15844/pedneurbriefs-3-6-10 Toxic Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Hyperbilirubinemia and Neurodevelopmental Outcome http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 06 1989 01 08 2016 3 6 47 48 Copyright: © 1989 The Author(s) 1989 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Hyperbilirubinemia in preterm infants and neurodevelopmental outcome at 2 years of age: results of a national collaborative survey

The results of the Collaborative Project on Preterm and Small for Gestational Age Infants in the Netherlands, 1983, in regard to hyperbilirubinemia and neurodevelopmental outcome at two years of age are reported from the Division of Neonatology, Department of Pediatrics, University Hospital, Leiden, the Netherlands.

 Gestational Age Infants Neurological Abnormalities Hyperbilirubinemia

The results of the Collaborative Project on Preterm and Small for Gestational Age Infants in the Netherlands, 1983, in regard to hyperbilirubinemia and neurodevelopmental outcome at two years of age are reported from the Division of Neonatology, Department of Pediatrics, University Hospital, Leiden, the Netherlands.

Children with minor and major handicaps had significantly greater maximal serum total bilirubin concentrations than children with a normal neurodevelopmental outcome (P = 0.02). An increase in prevalence of handicaps was found for each 50 mmol/L (2.9 mg/dL) increase of maximal serum total bilirubin concentration. The neurological abnormalities included cerebral palsy, seizures, hearing defects as well as retinopathy of prematurity. The risk of a handicap increased by 30% for each 2.9 mg/dL increase of maximal serum total bilirubin concentration (P = 0.02) suggesting a causal relationship. [1]

COMMENT. In the same issue, Newman TB and Maisels MJ comment that the strength of the association between bilirubin levels and brain damage in the present study was insufficiently precise to provide evidence of a strong causal relationship. The 95% confidence interval was wide, the association has not been consistent in other studies, and panic about bilirubin in the 6-12 mg/dL range is premature. They note that the NICHD collaborative phototherapy trial showed that bilirubin levels were reduced significantly by 4 mg/dL but this did not reduce the incidence of motor deficits or cerebral palsy and there was no effect on IQ scores. They estimate that even if the hyperbilirubinemia was toxic and causally related to neurologic damage, about 33 premature infants would need to be treated to prevent one case of neurologic handicap. To achieve similar benefit in term infants the number to be treated would be 333. Further studies are suggested.

 van de Bor M van Zeben-van der Aa TM Verloove-Vanhorick SP Brand R Ruys JH Hyperbilirubinemia in preterm infants and neurodevelopmental outcome at 2 years of age: results of a national collaborative survey Pediatrics 1989 Jun 83 6 915 20 2471139