Document Detail

Hyperbilirubinemia in preterm infants and neurodevelopmental outcome at 2 years of age: results of a national collaborative survey.
MedLine Citation:
PMID:  2471139     Owner:  NLM     Status:  MEDLINE    
As part of a prospective national survey of preterm and small for gestational age infants in the Netherlands, the relationship between maximal serum total bilirubin concentration in the neonatal period and neurodevelopmental outcome at the corrected age of 2 years was studied. Initially, 1,338 infants with a gestational age of less than 32 completed weeks and/or a birth weight of less than 1,500 g were enrolled in the study; 146 were subsequently excluded because of congenital malformations and 361 died during the study period. At the corrected age of 2 years, 831 children were available for follow-up. Children with minor and major handicaps had significantly greater maximal serum total bilirubin concentrations than children with a normal neurodevelopmental outcome (P = .02). A consistent increase in prevalence of handicaps was found for each 50-mumol/L (2.9 mg/dL) increase of maximal serum total bilirubin concentration. The handicaps consisted mainly of cerebral palsy. Logistic regression analysis involving seven suspected confounding factors (gestational age, birth weight, seizures, intracranial hemorrhage, respiratory distress syndrome, ventriculomegaly, and bronchopulmonary dysplasia) revealed that the odds ratio was 1.3. This indicates that, on a multiplicative scale, the risk of a handicap increased by 30% for each 50-mumol/L (2.9 mg/dL) increase of maximal serum total bilirubin concentration (P = .02). Further analysis treated bilirubin as a categorized exposure. A striking systematic increase was found, suggesting a causal relationship between maximal serum total bilirubin concentration and neurodevelopmental outcome.
M van de Bor; T M van Zeben-van der Aa; S P Verloove-Vanhorick; R Brand; J H Ruys
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatrics     Volume:  83     ISSN:  0031-4005     ISO Abbreviation:  Pediatrics     Publication Date:  1989 Jun 
Date Detail:
Created Date:  1989-07-06     Completed Date:  1989-07-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  915-20     Citation Subset:  AIM; IM    
Department of Pediatrics, University Hospital, Leiden, the Netherlands.
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MeSH Terms
Bilirubin / blood
Cerebral Palsy / blood,  epidemiology,  etiology
Child, Preschool
Developmental Disabilities / blood,  epidemiology*,  etiology
Follow-Up Studies
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / blood,  epidemiology*,  mortality
Infant, Small for Gestational Age
Jaundice, Neonatal / blood,  complications,  epidemiology*,  mortality
Multicenter Studies as Topic
Prospective Studies
Regression Analysis
Reg. No./Substance:
Comment In:
Pediatrics. 1990 Mar;85(3):379-80   [PMID:  2304793 ]
Pediatrics. 1993 Jan;91(1):164; author reply 165-6   [PMID:  8416494 ]
Pediatrics. 1993 Jan;91(1):164-5; author reply 165-6   [PMID:  7677968 ]

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