Relation of peak total serum bilirubin concentrations to neurodevelopmental outcome at 2 years of age in premature African neonates.

Abstract

As part of a wider survey of the neurodevelopmental outcome of neonates who received intensive care for various morbidities in the Middle-Belt region of Nigeria, the relationship between peak total serum bilirubin (PTSB) concentrations in the neonatal period and neurodevelopmental status at 2 years of age was evaluated in 159 children available for follow-up and assessment. The prevalence of handicaps (minor and major) increased consistently with increase in the PTSB concentration, commencing in the range of 151-200 mumol/l. Major handicaps evolved in association with PTSB concentrations above 201 mumol/l. The handicaps consisted mainly of cerebral palsy and mental retardation. Children with handicaps (minor and major) experienced greater PTSB concentrations than those with a normal neurodevelopmental outcome. The emergence of major handicaps from a mean (SD) moderate peak hyperbilirubinaemia of 241.1 (35.9) mumol/l in the African neonate is worthy of note and cause for concern.