Research On Prospective Neuropsychological Development Of Neonatal Hyperbilirubinemia

[Objective] Previous studies revealed discrepant conclusions on the existence of mental retardation in neonates with hyperbilirubinemia, which makes a further research of its potential influence on prospective neuropsychological development the subject of active concern. This paper is a continuation of the inconclusive subject, with an intention to evaluate the contingency of impaired mental development for neonatal hyperbilirubinemia, basing on the follow-up data of key indicators like the development quotient points, the distribution of temperament and the self-care ability in social life. To provide clinical basis on if hyperbilirubinemia in infants with no or minor neurologic symptoms in the neonatal period affects children,s prospective neuropsychological development.[Method] Our sample was composed of term infants clinically diagnosed as neonatal hyperbilirubinemia, and admitted to neonatal intensive care unit(NICU) in Fuzhou General Hospital of Nanjing Military Command during the period of January 2013 and June 2014. The jaundice occurred to these neonates within 24 to 48 hours before sent in and then, they received a combination of phototherapy, anti-infective and injection of gamma globulin, on the basis of both serum total bilirubin and infestation levels detected during preadmission testing. A total sixty-seven cases, namely the HB group, were provided with follow-ups for half to two years to exclude inborn error of metabolism as well as other diseases causing brain damages, including fetal distress in uterus, asphyxia and convulsion in newborn and hypoxic-ischemic encephalopathy(HIE). Another fifty-eight cases were selected at random from perfectly healthy neonates without medical records of HB and treated as the control group. The long-term neuropsychological states of development for half to two years’ old wereassessed each by development quotient, temperament plus survivability in general living. The result of t test was compared with that of chi-square test.[Result] The development quotients(DQ) for HB and control group were 92.09±5.279 and 93.83±8.816 respectively, neither of which were significantly different(t = 1.312, P=0.193).For subjects in the HB group, the number of temperament types of the slow-to-warm-up, difficult and intermediate-high totaled 19(28.36%), compared to 48 of the easy and intermediate-low types. For those in the control group, the numbers were 13(22.41%)and 45 correspondently, Compared with c2=0.577,P=0.448, resulting in no statistically significant difference at P> 0.05.The incidence of a deficiency in general living was 2.98%(2/67)for the HB group, while the figure of the controlled reduced to 1.72%, i.e. only 1 out of 58 cases. No statistical significance was ever indicated at P > 0.05 accordingly, with the result of two groups wasc2=0.561, P=0.657.[Conclusion] Receiving treatment early enough, newborns with neonatal hyperbilirubinemia were no longer exposed to the risk of underdevelopment of neuropsychology. Therefore, it is of great importance that early intervention be properly processed in order to prevent sequels and improve prognosis, and maintain the healthy neuropsychological development of the delicate infants.