Effect of Intensive Phototherapy on Bilirubin Induced Neurological Defect (BIND) Score in Neonates with Severe Hyperbilirubinemia

Abstract

Background: neonatal hyperbilirubinemia is a leading cause of morbidity and mortality in developing countries. Adverse consequences include neonatal mortality, classic manifestations of choreoathetoid cerebral palsy, isolated auditory impairment, and a diverse manifestation of subtle processing disorders because of BIND. Aim of the Work: the aim of the current study was to evaluate the effectiveness of intensive phototherapy on BIND score in neonates with severe hyperbilirubinemia. Patients and Methods: the current study is a prospective study conducted on 100 neonates with severe hyperbilirubinemia admitted to NICU at university Hospital, Faculty of Medicine, Al-Azhar University, Assuit, Egypt in the period between November 2017 and May 2018. The study group was divided into 2 groups, hemolytic and non-hemolytic hyperbilirubinemia groups. Results: regarding TSB and direct bilirubin at admission no significant difference was detected between both groups (p=0.543 and 0.632). Regarding TSB and direct bilirubin at discharge no significant difference was detected between both groups (p=0.712 and 0.213). Results show no significant change between hemolytic and nonhemolytic jaundice regarding rate of decline per hour of total bilirubin and direct bilirubin after 8 hs. No significant difference between study groups regarding BIND score at admission. At discharge, 95 (95%) neonates had BIND score 0 and 4 (4%) had BIND score 1-3. One neonate (1%) died before scoring. Conclusion: care must be taken not to delay the decision of exchange transfusion to the degree that endangers baby's life. BIND score can be used to assess the efficacy of intensive phototherapy in newborn with hyperbilirubinemia.