Prospective Cohort Study of Neurodevelopmental Outcomes following Extreme Neonatal Hyperbilirubinaemia

Abstract Objective To describe the incidence and neurodevelopmental outcomes following extreme neonatal hyperbilirubinaemia in an Australian cohort. Study Design A prospective cohort study of neurodevelopmental outcomes up to 3 years of age of infants born between 2010 and 2013 at ≥34 weeks’ gestation with TSB ≥450µmol/L and/or clinical signs of acute bilirubin encephalopathy. Kernicterus was defined as two consistent signs of adverse neurodevelopment consistent or bilateral lesions of the basal ganglia or midbrain on MRI. Results Follow-up assessment data was available for 26 out of 56 children. Three children had neurodevelopmental impairment: one has GMFCS level 4 CP, audiological deficiency and visual impairment, the second has GMFCS level 1 CP and the third, global developmental delay with autism spectrum disorder. The estimated incidence of kernicterus in this cohort is 0.35 per 100 000 live births. Conclusion Kernicterus continues to occur in high-income settings. Healthcare should be optimised to achieve prevention.