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Hyperbilirubinemia Not Linked to Later Neurologic Deficit

Study finds no difference in neurodevelopmental tests compared with control children

WEDNESDAY, May 3 (HealthDay News) -- Infants with elevated levels of bilirubin who are treated with either phototherapy or exchange transfusion show neurodevelopmental progress similar to that of normal children, according to a report in the May 4 issue of the New England Journal of Medicine.

Thomas B. Newman, M.D., M.P.H., from the University of California San Francisco, and members of the Jaundice and Infant Feeding Study Team examined 140 infants with bilirubin levels of 25 mg per deciliter or more, most of whom were treated with phototherapy, to determine signs of neurologic deficit in early childhood. The study included 419 control children.

The authors found no signs of kernicterus at a mean follow-up of 5.1 years. In addition, the sample and control groups did not differ in cognitive tests, physical neurologic exams or documented history of neurologic abnormalities. In fact, fewer children in the sample group had questionable or abnormal neurologic findings than the controls (17 percent versus 29 percent, respectively).

Most of the infants in the study were born at term, had bilirubin levels above 25 mg/dL for six hours or less and levels at 20 mg/dL for less than 24 hours, according to an editorial. "Nevertheless, these data provide reassurance that total serum bilirubin levels between 20 and 25 mg/dL…are unlikely to put an infant at risk for acute bilirubin encephalopathy in the absence of other contributing factors," Jon F. Watchko writes.

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