Current Trends of the Hyperbilirubinemia and the Results of Auditory Evoked Potential

Bin, Joong Hyun; Kim, So Young

Abstract

OBJECTIVE
: The purpose of this study was to identify the current trends of the incidence of hyperbilirubinemia and the results of the auditory evoked potential and to evaluate the correlation with early and late evidence of bilirubin-induced brain injury.
METHODS
: We reviewed the medical records of all neonates who were admitted to the Holy family hospital of CUMC exclusively for management of neonatal jaundice from January, 2002 to December, 2006. The gestational age, the age at peak bilirubin level, the peak bilirubin level, feeding method and brainstem auditory-evoked potential (AEP) were reviewed.
RESULTS
: We investigated 121 term and 101 preterm infants treated for management of neonatal jaundice. The mean peak bilirubin values of term and preterm infants were 22.7+/-0.5 and 13.7+/-0.3 mg/dL. The mean age at peak bilirubin level of term and preterm infants were 7.5+/-0.5 and 4.7+/-0.2 days. All were breastfed (46.3% vs. 30.7%) or fed a combination of breast and bottle feedings (53.7% vs. 44.5%) in term and preterm infants. Comparison of peak bilirubin levels and age at peak bilirubin level in the serum of term and preterm group with AEP results showed no significant relationship. Trend in peak serum indirect bilirubin level in term infants were significantly increased in the recent 3 years. Trend in AEP abnormality showed no significant changes during the study periods. Only two preterm infant showed abnormal AEP at follow up study.
CONCLUSION
: Recently, increased frequency of breast-feeding, shortened hospital stays, and inconsistent follow-up after hospital discharge may cause the increased incidence of severe hyperbilirubinemia in healthy preterm and term newborn infants. But it is not clear such early onset hyperbilirubinemia may cause acute bilirubin encephalopathy or permanent brain injury.