NEUROBEHAVIORAL DEFICITS IN MODERATELY JAUNDICED TERM INFANTS

Abstract

We used Brazelton's Neonatal Behavioral Assessment Scale (NBAS) and auditory brainstem evoked responses (ABER) to evaluate moderately jaundiced term infants for neurobehavioral deficits. To evaluate behavioral deficits, an examiner blinded to jaundice by specially-tinted contact lenses, performed NBAS on 20 otherwise healthy, jaundiced infants (bilirubin=12-17mg%) prior to phototherapy and 20 healthy controls matched for race, sex, age, delivery mode, and feeding method. Unexpected differences in gest. age and BW favored controls (39.9 vs. 39.1 wks; 3225 vs. 2938g) but had no significant effect on NBAS summary variables. NBAS mean scores consistently favored controls (28/37 NBAS items; p<0.01). 20 more infants will be assessed to verify jaundice-related effects. To evaluate possible ABER deficits, 30 otherwise healthy, term jaundiced infants (total bilirubin 10-15mg%) and 12 healthy, term controls were studied. ABER reliability was verified. Latency of Wave V but not Wave I in jaundiced infants exceeded controls (p<.01). Similar patterns were observed for ABER amplitudes. Response to phototherapy was variable. NBAS and ABER findings prior to phototherapy are similar to those reported at higher bilirubin levels with phototherapy. Bilirubin levels previously considered innocuous are probably associated with alterations in both brainstem function and infant behavior.