Neurodevelopmental outcome at 1 year in Zimbabwean neonates with extreme hyperbilirubinaemia.

ABSTRACT

PIP: The effect of maximum total serum bilirubin (TSB) in excess of 400 mcgmol/l (23.4 mg/dl) on neurodevelopmental outcome at 12 months was assessed in a follow-up study of 50 infants admitted to the Special Baby Care Unit of Mpilo Central Hospital in Bulawayo, Zimbabwe. There were 26 preterm infants (52%) in this series. 2 infants died before they reached 12 months of age and 5 were lost to follow-up. TSB levels were not associated with either birth weight or gestational age. Overall, 32 infants (74%) had Bayley Scales of Infant Development scores within the normal range. 11 (26%) of the 43 infants with extreme TSB (above 482 mcgmol/l) had suspect or abnormally low scores on the Bayley Scales and 5 of these infants (12%) developed the choreo-athetoid type of cerebral palsy. The infants with TSB levels of 400-500 mcgmol/l who had suspect or abnormal Bayley scores either had hemolytic disease or were premature. Finally, infants treated with exchange transfusion had higher TSB levels and 67% of transfused newborns demonstrated delayed development at 12 months of age.