Page 234 - 16Neonatal Jaundice_compressed

Neonatal jaundice

Bibliographic details Study type and Patient characteristics Methodology and interventions Results Reviewers Comments
Evidence level
Country: USA Evidence Level: II one bilirubin level recorded done depending on the initial Partially blinded (some tests)
levels No statistically significant association was
23
n = 41 324 seen between high TSB levels and IQ
Mean BW: 3285 g Outcomes scores or sensorineural hearing loss.
Mean GA: 39.3 ± 2.8 weeks intelligence quotient (IQ)
Gender: males = 51.3% assessment by psychologists Abnormal neurological examination was
(using Wechsler Intelligence
reported more commonly in children with
Ethnicity: Scale for Children) at the age of high TSB levels (= 342 micromol/litre)
White = 51.7% 7 years, compared to those with lower TSB levels,
Black = 48.3% neurological examination by but the difference was statistically not

Exclusion criteria: paediatric neurologists or significant (4.5% vs 3.8%; RR 1.2, 95% CI
specially trained paediatricians at
0.7–2.1).
Non-singleton babies the age of 7 years
Birthweight < 2500 or birthweight hearing evaluation performed at However it was observed that there was a
unknown
8 years of age using pure-tone significant linear increase in the risk of
audiometry ‘suspicious’ abnormal neurological
examination with an increase in the TSB
Multiple logistic regression levels (OR 1.12, 95% CI 1.06- 1.2).
analysis was performed to
control for the effect of 11
potential confounding variables

Boo NY et al.; Study Type: 136 jaundiced term neonates. Hearing loss was based on brain Hearing loss:
Cohort study stem-evoked response. 28/128 (21.8%)
Year:1994 n = 128
Evidence Level: II Mean BW: 3022 + 474 g Hyperbilirubinaemia defined as Hearing loss:
Country: Malaysia Mean GA: 39.8 + 0.7 weeks TSB > 340 micromol/litre TSB < 340 micromol/l
Gender: males = 62.5% 13/83 (15.7%)
25 Ethnicity: TSB > 339 micromol/l
Malays = 50.8% 15/45 (33.3%)
Chinese = 35.9% P = 0.11
Indian = 10.9%
Others = 2.3% Risk factors for hearing loss

8 babies were excluded due to Severe jaundice which required exchange
aminoglycoside treatment and transfusion (P = 0.038)
Earlier age of onset of hyperbilirubinaemia
congenital anomalies (P = 0.012)

Oh W et al.; Study Type: Extremely low birthweight infants Demographic and clinical risk 3,246 infants survived at discharge, 79 PSB concentrations during the first
Retrospective (401–1000 g) who survived to factors died 2weeks of life are directly correlated with
Year:2003 cohort study 14 days of age and serum bilirubin levels during after discharge, and 592 were lost to death or NDI,
the first 14 days were analysed follow-up. 2575 of 3167 infants were seen hearing impairment, and PDI < 70 in
Country: USA Evidence Level: II n = 5630 with reference to death or in the follow-up clinics extremely low birthweight infants.
mean BW: 789 ± 136 g adverse neurodevelopmental with a compliance rate of 81%.
24 outcomes at 18 to 22 months’
mean GA: 26.2 ± 2.1 weeks postmenstrual age. Logistic regression analysis

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