Five and Nine Year Check‐up of 314 Children with Neonatal Hyperbilirubinaemia

Michelsson, Katarina; Lindahl, Elina; Helenius, Maija; Parre, Marjatta

doi:10.1080/0300443880300113

Cited by 3 publications

(6 citation statements)

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“…Also the children with neonatal hyperbilirubinemia managed less well in neurological and psychological tests at the age of 5 years. They had poorer school grades and more often attended special classes for somatically or mentally disabled at the age of 9 years, but their results were still often better than in the rest of the risk group 11 . The children born during 1972–73 were analyzed for minor and major congenital anomalies.…”

Section: Methods and Outcomes In Childhoodmentioning

confidence: 92%

“…The questionnaire also included the Barkley Current Symptoms Scale as well as the Childhood Symptoms Scale 11 .…”

Section: Methods and Outcomes In Childhoodmentioning

confidence: 99%

“…This is a prospective longitudinal at-risk cohort study of a 1971–1974 birth cohort that has been prospectively followed to adulthood 1 . Several papers, theses, and book chapters about the findings in children up to the age of 16 years have been published based on this material 2– 11 . Therefore, we know the individuals that are in different outcome groups and etiologies.…”

Section: Introductionmentioning

confidence: 99%

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The Perinatal Adverse events and Special Trends in Cognitive Trajectory (PLASTICITY) - pre-protocol for a prospective longitudinal follow-up cohort study

2013

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Prospective follow-up studies on long term effects of pre- and perinatal adverse conditions in adulthood are rare. We will continue to follow the prospective cohort of initially 1196 subjects with predefined at-delivery risk factors out of 22,359 consecutive deliveries during 1971-74 at a single maternity hospital. The risk cohort and 93 controls have been followed up with a comprehensive clinical program at 5, 9, and 16 years of age and by questionnaire at the age of 30 years. Major medical events known to affect the development and growth of the brain, or cognitive functions and personality have been documented. Here we present a pre-protocol for the project, which we will call PLASTICITY, whose aim is to follow consenting subjects and controls into mid-adulthood and beyond, and to explore how the neonatal risk factors modulate neurodevelopmental and neurodegenerative processes such as learning disabilities, ADHD, aging, early onset mild cognitive impairment and even dementia. Our first focus is on the neurological and cognitive outcomes at age 40 years, using detailed neurological, neuropsychological, neuroimaging, genetic, blood chemistry and registry based methods. Results will be expected to offer information on the risk of neurological, psychiatric, metabolic and other medical consequences as well as the need for health and social services at the brink of middle age, when new degenerative phenomena are known to emerge. The evaluation at age 40 years will serve as a baseline for later aging studies. We welcome all comments and suggestions, which we will apply in finalizing details and inviting collaboration.

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Section: Methods and Outcomes In Childhoodmentioning

confidence: 92%

“…The questionnaire also included the Barkley Current Symptoms Scale as well as the Childhood Symptoms Scale 11 .…”

Section: Methods and Outcomes In Childhoodmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Perinatal Adverse events and Special Trends in Cognitive Trajectory (PLASTICITY) - pre-protocol for a prospective longitudinal follow-up cohort study

2013

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“…[60][61][62][63][64][65][66][67][68] However, in a larger Helsinki study, infants with TSB > 20 mg/dL or who received exchange transfusion (n = 244) had significantly lower performance IQ compared to control infants (n = 44) when evaluated at 9 years of age. 69 Several other studies involving preterm and/or term infants had findings that suggest hemolysis or infection-associated UHB may lead to cognitive delay. [70][71][72][73][74][75][76] Among late preterm and term infants with TSB ≥ 25 mg/dL, 9 infants with hemolysis (direct antiglobulin test [DAT] positive) had significantly lower IQ than infants without hemolysis.…”

Section: Clinical Studies Of the Association Between Uhb And Nddsmentioning

confidence: 99%

“…Using a teacher questionnaire, Michelsson et al reported that the frequency of poor total school marks and amount of extra help by class teacher, special education teacher, and speech-language pathologist at 9 years was significantly higher among infants with TSB > 20 mg/dL or those who had exchange transfusion for UHB (n = 256) compared to control subjects (n = 72). 69 A similar group of term infants with TSB > 20 mg/dL were followed for their neurobehavioral outcome at 9 years of age and educational outcome at 30 years of age. 93 Neurobehavioral disability was seen at 9 years of age among 57 out of 128 children with UHB compared to 12 out of 82 children in the control group without UHB (odds ratio 4.6, 95% CI: 2.2-10.1).…”

Section: Clinical Studies Of the Association Between Uhb And Nddsmentioning

confidence: 99%

Developmental influence of unconjugated hyperbilirubinemia and neurobehavioral disorders

2018

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Adult neurobehavioral outcome of hyperbilirubinemia in full term neonates—a 30 year prospective follow-up study

Hokkanen

Launes

Michelsson

2014

PeerJ

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Background. Neonatal hyperbilirubinemia (HB) may cause severe neurological damage, but serious consequences are effectively controlled by phototherapy and blood exchange transfusion. HB is still a serious health problem in economically compromised parts of the world. The long term outcome has been regarded favorable based on epidemiological data, but has not been confirmed in prospective follow-up studies extending to adulthood.Methods. We studied the long term consequences of HB in a prospective birth cohort of 128 HB cases and 82 controls. The cases are part of a neonatal at-risk cohort (n = 1196) that has been followed up to 30 years of age. HB cases were newborns ≥ 2500 g birth weight and ≥ 37 weeks of gestation who had bilirubin concentrations > 340 µmol/l or required blood exchange transfusion. Subjects with HB were divided into subgroups based on the presence (affected HB) or absence (unaffected HB) of diagnosed neurobehavioral disorders in childhood, and compared with healthy controls. Subjects were seen at discharge, 5, 9 and 16 years of life and parent’s and teacher’s assessments were recorded. At 30 years they filled a questionnaire about academic and occupational achievement, life satisfaction, somatic and psychiatric symptoms including a ADHD self-rating score. Cognitive functioning was tested using ITPA, WISC, and reading and writing tests at 9 years of life.Results. Compared to controls, the odds for a child with HB having neurobehavioral symptoms at 9 years was elevated (OR = 4.68). Forty-five per cent of the HB group were affected by cognitive abnormalities in childhood and continued to experience problems in adulthood. This was apparent in academic achievement (p < 0.0001) and the ability to complete secondary (p < 0.0001) and tertiary (p < 0.004) education. Also, the subgroup of affected HB reported persisting cognitive complaints e.g., problems with reading, writing and mathematics. Childhood symptoms of hyperactivity/impulsivity (p < 0.0001) and inattention (p < 0.02) were more common in HB groups, but in adulthood the symptoms were equal. The affected HB had lower scores in parameters reflecting life satisfaction, less controlled drinking, but not increased substance abuse.Discussion. Our results indicate that neonatal HB has negative consequences in adult age. A prospectively collected cohort with strict inclusion criteria enables to control most of the bias factors involved with retrospective data. The control and HB groups were remarkably similar at birth in terms of medical data, and the growth environment of the children, as well as the parents’ social groups, education, size of family, type of housing at birth and at 9 years of age. Our findings bear resemblance to disorders of the fronto-striatal network, and also symptoms of the ADHD spectrum were frequent in the HB group suggesting a link of HB to other neurodevelopmental disorders.

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Five and Nine Year Check‐up of 314 Children with Neonatal Hyperbilirubinaemia

Cited by 3 publications

References 15 publications

The Perinatal Adverse events and Special Trends in Cognitive Trajectory (PLASTICITY) - pre-protocol for a prospective longitudinal follow-up cohort study

The Perinatal Adverse events and Special Trends in Cognitive Trajectory (PLASTICITY) - pre-protocol for a prospective longitudinal follow-up cohort study

Developmental influence of unconjugated hyperbilirubinemia and neurobehavioral disorders

Adult neurobehavioral outcome of hyperbilirubinemia in full term neonates—a 30 year prospective follow-up study

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