Clinical Analysis And Follow-up Of 129 Cases With Neonatal Severe Hyperbilirubinemia

Objective: Investigating the clinical features and outcome of neonatal severe hyperbilirub inemia to provicde evidence for better prevention and treament,and to improve poor outcome.Methods:Analys ising clinical and follow-up data of newborns diagnosed with severe hyperb ilirubinemia hospitalized during July 2013 to December 2014 in our hospital.Results:(1)129 cases of neonatal severe hyperbilirubinemia were included,the gender ratio was 1.80:1. 30 cases were with b ilirub in encephalopathy(BE). The average birth-weight of BE group group was lower than the control group,and the pretem rate was higher than the control group(P<0.05).(2) About etio logy,67 cases(51.9%) were with G6 PD defic ioncy,42 cases(32.6%) were with unknown reason,24 cases(18.6%) were with infection, 23 cases(17.8%) were with ABO hemo lytic.(3)The average peak TSB and B/A ratio of BE group were higher than the control group(P<0.05).(4)63 cases checked BAEP,16 cases were hearing impairment,7 of 9 children with severe or extreme hearing impairment were improved by recieving rehabilitation.(5) 14 of 22 BE cases had hyperintense signal on T1 WI, and 30 of 52 cases without BE had hyperintense signal on T1 WI.(6)Follow-up of 101 cases, 36 cases were with poor outcome. The average birth-weight of poor outcome group were lower than the control group(P<0.05).The pretem rate,the average peak TSB and B/A ratio of poor outcome group were higher than the control groups(P<0.05). the poor outcome rate of BE group were higher than the control group(P<0.05).8 children with central coordination disorder and 2cases with cerebral palsy were improved by recieving rehabilitation,4 central coordination disorder recovered before 1-year old.Conclusions:(1) Neonatal severe hyperbilirubinemia with low birth-weight and pretem appeared to cccur BE and poor outcome.(2)In our study,the common etiology of neonatal severe hyperb ilirubinemia were G6 PD defic iency,unknown reason,infection and ABO hemo lytic.(3)The higher the peak TSB and B/A ratio,the greater to appear BE and poor outcome.(4) Hyperintense globus pallidus on T1 WI and neurological find ing may not always correlate.(5) Rehab ilitation might improved hearing impairment and central coordination disorder and cerebral palsy.