GANGGUAN PERKEMBANGAN NEUROLOGIS PADA BAYI DENGAN RIWAYAT HIPERBILIRUBINEMIA

Abstract

Background : Hyperbilirubinemia, as one of the major cause of neurodevelopmental disorders (NDD) leads to permanent damage of the brain cell. Indirect bilirubin of the blood serum (IBS) is important since its capabilities to infiltrate blood brain barrier (BBB). BBB damage can increase brain permeability of bilirubin. There are many factors involving the damage process of this BBB, which subsequently increasing risk factors of neurodevelopmental disorders. Objective : To define the correlation between the value of neonatal IBS and the risk of NDD. Methods : A prospective longitudinal study was done among 48 neonates admitted to Dr. Kariadi Hospital with IBS level >10 mg/dL since October 2004-August 2005. Follow-up was done at the age of 3, 6, and 9 months with Bayley Infant Neurodevelopmental Screener (BINS) scoring system. Statistical analyses was performed using Spearman analysis, Receiver Operating Curve and Cox-regression analysis. Results: Mean IBS level of subject with NDD risk was 20.5 mg/dL (SD=6.06;p<0.001), 19 (39.6%) subjects had NDD risk. There was significant correlation between IBS level and the onset of NDD (R=-0.63; p< 0.001). Receiver Operating Curve (ROC) showed IBS level could be used as outcome predictor for NDD among babies, with BIS cut-off point 14.68 mg/dL. There was significant