title: Neurodevelopmental outcome of acute bilirubin encephalopathy.
abstract: The aim of the study was to determine the neurodevelopmental outcome of acute bilirubin encephalopathy (ABE) in children who underwent double volume exchange transfusion (DVET). The 25 referred newborns of ≥ 35 weeks gestation with total serum bilirubin >20 mg dl(-1) and signs of ABE were enrolled and followed up at 3, 6, 9 and 12 months. Denver Development Screening Test (DDST), Neurological examination along with MRI at discharge and brain stem evoked response audiometry (BERA) at 3 months were done. Abnormal neurodevelopment was defined as either (i) cerebral palsy or (ii) abnormal DDST or (iii) abnormal BERA. The mean bilirubin at admission was 37 mg dl(-1). MRI and BERA were abnormal in 61% and 76%. At 1 year, DDST and neurological abnormality were seen in 60% and 27% and 80% had combined abnormal neurodevelopment. MRI had no relation (P = 0.183) but abnormal BERA had a significant association (P = 0.004) with abnormal outcome. Intermediate and advanced stages of ABE associated with significant adverse outcome in spite of DVET.
authors.affiliation: Neonatal Unit, Department of Pediatrics, PGIMER, Chandigarh, India. kanyapupul@yahoo.com
authors.forename: Kanya
authors.initials: K
authors.lastname: Mukhopadhyay
authors.forename: Gurdev
authors.initials: G
authors.lastname: Chowdhary
authors.forename: Paramjeet
authors.initials: P
authors.lastname: Singh
authors.forename: Praveen
authors.initials: P
authors.lastname: Kumar
authors.forename: Anil
authors.initials: A
authors.lastname: Narang
mesh_terms: D001299:Audiometry; D001663:Bilirubin / Q000097:blood*; D001921:Brain / Q000503:physiopathology; D002547:Cerebral Palsy / Q000209:etiology; D002657:Child Development / Q000502:physiology*; D004453:Echoencephalography; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D005078:Exchange Transfusion, Whole Blood; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000097:blood / Q000453:epidemiology; D007647:Kernicterus / Q000150:complications / Q000453:epidemiology / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination / Q000379:methods; D016896:Treatment Outcome
chemical_list: D001663:Bilirubin