ABSTRACT
Background: Neonatal hyperbilirubinemia is an important cause of preventable brain damage among infants. Neurodevelopmental assessment and Brainstem Evoked Response Audiometry BERA may help in early identification and management of neurodevelopmental sequelae. Objectives: To find the association between neonatal peak serum bilirubin levels and the neurodevelopmental outcomes at 6 months in term infants with neonatal hyperbilirubinemia and to assess the changes in Auditory Brainstem Responses of these neonates. Methods: Prospective cohort study was conducted in the Department of Pediatrics, Gandhi Medical College, Bhopal. All healthy, full term, appropriate for date neonates, admitted from December 2014 to June 2015 for hyperbilirubinemia and had serum bilirubin > 12 mg/dL were included in the study and were followed up till 6 months of age. The neurodevelopmental assessment was done using DDST II and BERA was done at an average age of 69±6 days. Results: Total 77 newborns were enrolled and 73 completed the study. 40/77 (51.65%) had abnormal BERA results while 3/77 (3.9%) had neurodevelopmental abnormalities. BERA and neurodevelopmental abnormalities were associated with mean serum bilirubin of 22.58mg/dL and 31.33mg/dL respectively. The cut-off value of serum bilirubin was 16.3mg/dL and 23.8mg/dL respectively to detect BERA and neurodevelopmental abnormalities respectively. All patients (11) who received exchange transfusion had BERA abnormalities and 3/11 (27.3%) had neurodevelopmental abnormalities. The association of ABO incompatibility was significant (p<0.001) with abnormal BERA. CONCLUSION: Serum bilirubin is linearly associated with BERA and neurodevelopmental abnormalities. Patients receiving exchange transfusion have higher odds of neurodevelopmental sequelae. Regular follow-up and early intervention may help infants to have better neurodevelopmental and auditory outcomes.
Keywords: Auditory Brainstem Responses, Neonatal hyperbilirubinemia, Neurodevelopmental