124 Long-term neurodevelopmental outcomes of preterm infants with systemic hypertension - A population-based study
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Journal Article 124 Long-term neurodevelopmental outcomes of preterm infants with systemic hypertension - A population-based study Get access Beth Ellen Brown, Beth Ellen Brown Neonatal-Perinatal Medicine Section Search for other works by this author on: Oxford Academic Google Scholar Philip Acott, Philip Acott Neonatal-Perinatal Medicine Section Search for other works by this author on: Oxford Academic Google Scholar Michael Vincer, Michael Vincer Neonatal-Perinatal Medicine Section Search for other works by this author on: Oxford Academic Google Scholar Colleen O’Connell, Colleen O’Connell Neonatal-Perinatal Medicine Section Search for other works by this author on: Oxford Academic Google Scholar Andrzej Kajetanowicz, Andrzej Kajetanowicz Neonatal-Perinatal Medicine Section Search for other works by this author on: Oxford Academic Google Scholar Walid El-Naggar Walid El-Naggar Neonatal-Perinatal Medicine Section Search for other works by this author on: Oxford Academic Google Scholar Paediatrics & Child Health, Volume 24, Issue Supplement_2, June 2019, Pages e48–e49, https://doi.org/10.1093/pch/pxz066.123 Published: 31 May 2019Keywords:
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Perinatal medicine
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Neurological examination
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Summary One hundred and thirteen full‐term infants with bilirubin values of 18 mg% or more during the neonatal period, have been followed‐up at the age of 2–3 years, and compared with 51 full‐term, non‐icteric infants, born during the same period. Exchange transfusion was carried out in 30 of the children with jaundice. No cases of kernicterus could be demonstrated. Play audiometry was carried out in 125 children (86 with jaundice, 39 controls). No deafness of central type was revealed. At the paediatric follow‐up examination no relevant abnormalities were found. Merrill‐Palmer testing produced evidence of a similar I.Q. distribution among the icteric as among the non‐icteric children. A cerebral lesion was diagnosed in 3 cases, but in all these another aetiology (disturbance at the time of birth) occurred in addition to hyper‐bilirubinaemia. Hyperbilirubinaemia alone did not give rise to any cerebral lesion.
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Critical evaluation of guidelines for treatment of hyperbilirubinaemia in healthy full-term newborns, based on literature data concerning effects of hyperbilirubinaemia on later development.Structured literature survey.Groningen, the Netherlands.By electronic and hand searching of literature according to published guidelines data were collected on the relation between the peak total serum bilirubin concentration (TSB) in the first week of life and later development.One large study, the Collaborative Perinatal Project (CPP), showed statistically significant negative associations of TSB in the first week of life with Bayley development score at age 8 months, intelligence quotient (IQ) at age 4 years, and unspecified neurological abnormalities at age 7-8 years. In other studies, with considerable less power than the CPP, no such findings were made. In the original analyses of the CPP no correction was made for confounders and effect modifiers; after correction for such variables, a relation between TSB in the first week of life and later development was no longer found. At the age of 6 years, no statistically significant differences in IQ, hearing, and neurological abnormalities were found between children who, as newborns, had or had not been treated with phototherapy because of hyperbilirubinaemia.Treatment for jaundice in healthy full-term newborns is only indicated at considerably higher serum bilirubin levels than those recommended previously.
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Neonatology
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This chapter contains section titled: Section 104: Construction contracts Section 105: Meaning of ‘construction operations’ Section 106: Provisions not applicable to contract with residential occupier Section 107: Provisions applicable only to agreements in writing Section 114: The Scheme for Construction Contracts Section 115: Service of notices, & c. Section 117: Crown application Section 146: Orders, regulations and directions Section 148: Extent Section 149: Corresponding provision for Northern Ireland Section 150: Commencement Section 151: Short title
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SUMMARY A follow‐up study is presented of 93 full‐term infants with neonatal hyperbilirubinaemia, 46 of which were treated by exchange transfusion. At examination between 2 and 2 1/2 years of age no differences with regard to neurological abnormalities or development could be demonstrated between the two groups. No definite signs of kernicterus were present in any case. One child with congenital hypothyroidism showed a minor disturbance in coordination not apparent until the age of 4 years.
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Summary
One hundred and thirteen full-term infants with bilirubin values of 18 mg% or more during the neonatal period, have been followed-up at the age of 2–3 years, and compared with 51 full-term, non-icteric infants, born during the same period. Exchange transfusion was carried out in 30 of the children with jaundice. No cases of kernicterus could be demonstrated. Play audiometry was carried out in 125 children (86 with jaundice, 39 controls). No deafness of central type was revealed. At the paediatric follow-up examination no relevant abnormalities were found. Merrill-Palmer testing produced evidence of a similar I.Q. distribution among the icteric as among the non-icteric children. A cerebral lesion was diagnosed in 3 cases, but in all these another aetiology (disturbance at the time of birth) occurred in addition to hyper-bilirubinaemia. Hyperbilirubinaemia alone did not give rise to any cerebral lesion.
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Safety of moderate hyperbilirubinemia in healthy term neonates is still a matter of discussion. The purpose of this study was to compare developmental status of 18-month-old children with and without history of neonatal indirect nonhemolytic hyperbilirubinemia.In a case-control study, the developmental status of 18-month-old children referred to Azadshar primary health care center in Yazd, Iran, between December 2007 and June 2009 was evaluated via the Persian version of Ages and Stages Questionnaires (ASQ). Children in the case group were healthy term neonates with total serum bilirubin level of 20-25 mg/dl, birth weight of 2500-4000 g and no birth asphyxia who were admitted to hospital and had undergone phototherapy. The control group consisted of children who were healthy term neonates without history of neonatal hyperbilirubinemia.112 children (56 in each group) were evaluated. Four children in the case group and one in the control group had delay in communication skills. Three in the case group and three in the control group had fine motor delay. Only one child in the case group showed delay in problem solving. Statistically significant differences were not seen in the frequency of developmental delay as well as in the mean scores of all developmental domains in both groups.Based on the results of the present study by ASQ, the developmental status at the age of 18 months of healthy term neonates with moderate unconjugated hyperbilirubinemia was not different from the control group.
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Unconjugated hyperbilirubinemia
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