Adverse effects of hyperbilirubinemia on the development of healthy term infants

Abstract

Background Indirect hyperbilirubinemia is a common problem dur- ing the neonatal period and may cause long-term abnormality or developmental delay. Objective To evaluate the adverse effects of hyperbilirubinemia on the development of healthy term infants. Methods This was a prospective cohort study on healthy term infants born in Sanglah Hospital, Denpasar. Mullen Scale Tests were performed at the ages of 3 and 6 months to assess subjects’ development. Bivariate and multivariate analyses were conducted to examine the relationship between several dependent variables and developmental outcomes. Results One hundred and twelve infants were enrolled in this study [56 with hyperbilirubinemia, 56 without hyperbilirubinemia; 58 (52%) male, 54 (48%) female]. Mean birth weight was 318.3 grams (SD 342.26) vs 3162.5 grams (SD 338.61). At the age of 3 months, below average category according to Mullen Scale Test was higher in infants with history of hyperbilirubinemia compared to those with- out hyperbilirubinemia, which was statistically significant for fine motor scale (17.9% vs 5.4%; respectively; P=0.039; RR 1.66; 95% CI 1.15;2.39). At 6 months of age, it was higher in infants with history of hyperbilirubinemia compared to those without hyperbi- lirubinemia and this was statistically significant for gross motor scale (19.6% vs 3.6%, respectively; RR 1.86; 95%CI 1.36; 2.56; P=0.008) and fine motor scale (17.9% vs 5.4%, respectively; RR 1.66; 95%CI 1.15; 2.39; P=0.039). Multivariate logistic regression test showed that only hyperbilirubinemia was correlated with gross motor scale delay at the age of 6 months (P=0.027; OR 5.97; 95%CI 1.22; 29.12). Conclusion Healthy term infants with history of hiperbilirubinemia were associated with increased gross motor scale delay at the age of 6 months

Keywords

• healthy term infants
• hyperbilirubinemia
• gross motor scale delay
• Mullen Test