Learning Disabilities and raised Bilirubin

[RR1]

Does anyone have any information on how long Bilirubin levels in neonates can remain raised before they cause permanent damage, assessed as any degree of learning disabilities, hearing impairment etc, diagnosed in primary school children?

[L106]

I have never been told (or read of) specific correlations between the length of time of elevated bilirubin and the various detrimental effects. I would imagine that there are too many variables involved (maturity of the newborn, treatments administered, methods of intellectual testing, etc) to come up with a definitive answer to your question. (However, if you find an answer, please post it here, OK? Thanks, Rashmi!)

[Malcolm Needs ☆]

I have never been told (or read of) specific correlations between the length of time of elevated bilirubin and the various detrimental effects. I would imagine that there are too many variables involved (maturity of the newborn, treatments administered, methods of intellectual testing, etc) to come up with a definitive answer to your question. (However, if you find an answer, please post it here, OK? Thanks, Rashmi!)

I would tend to agree.

[RR1]

I have been looking around on the internet and there are articles stating that Kernicterus can occur within a few days with elevated bilirubin. Therefore I suppose this could cause learning difficulties quite rapidly.

I remember a old colleague of mine stating that the deaf school he had attended had many pupils that were 'jaundiced' babies, and the link with hyperbilrubinaemia and deafness is now known. I was just trying to find out if there were also othe types of L.d that could be associated too.

[Malcolm Needs ☆]

Most certainly there are.

Blindness si also associated with kernicterus, as is opisthotonus.

As the deafness is "caused" in the brain, rather than in the ears with kernicterus, there can be multiple disabilities.

[RR1]

Just shows how important the work we do is. Sometimes we don't always think around the consequences of equipment or tests not working properly or robustly. Antibodies missed during antenatal testing can have devastating consequences for the child as well as the family.

[Malcolm Needs ☆]

Indeed, they can be fatal.

[RR1]

Yes they can be fatal, but i'm mainly concerned when I hear folk sometimes state that a missed antibody will just cause 'a little jaundice' in the baby. What if that baby was discharged and problems were not recognised in time?

These children and their families go through an awful lot throughout their lives, I find it very distasteful when I hear folk dismissing failure of their automation in detecting certain antibodies as being inconsequential.

I presume these are all SABRE/ SHOT reportable events too.

[Malcolm Needs ☆]

Yes they can be fatal, but i'm mainly concerned when I hear folk sometimes state that a missed antibody will just cause 'a little jaundice' in the baby. What if that baby was discharged and problems were not recognised in time?

These children and their families go through an awful lot throughout their lives, I find it very distasteful when I hear folk dismissing failure of their automation in detecting certain antibodies as being inconsequential.

I presume these are all SABRE/ SHOT reportable events too.

One would sincerely hope so.

The number of babies affected by ABO HDN is increasing simply because mother and baby are being discharged so quickly after the birth. Of course, the mother is not trained to notice anything odd, and so the babies are being brought back in in extremis, rather than them being treated with phototherapy in the hospital (although, of course, this is hardly the fault of the Blood Banks).

:eek::eek:

[RR1]

I found the following article below (which is similar to a report published in the current NewScientist ), concerning neonatal jaundice and autism/developmental disorder links;

Study ties jaundice to autism risk

LOS ANGELES — Researchers may have discovered a possible link between jaundice in newborns and an increased risk of psychological development difficulties, including autism. Danish scientists looked at data on the 733,826 live births in Denmark between 1994 and 2004. In that group, 35,766 were diagnosed with neonatal jaundice, a fairly common illness in babies that usually goes away within a week of birth. During the study period, 1,721 children were diagnosed with a psychological development disorder, and 4,257 children died. Being exposed to jaundice for children born at full term resulted in a 56 percent to 88 percent increased risk of acquiring a psychological development disorder and a 67 percent increased risk for infantile autism. The study was published online in the journal Pediatrics.

[SMW]

You may find the attached article (and the associated references) of interest.........

hyperbilirubinemiamgmt.pdf

[L106]

Thanks, SMW! A brief article came out in many newspapers in the USA just a week or two ago (hinting at a link between jaundice and learning disabilities.) I appreciate having access to the article you attached to your post.

Donna

[RR1]

Nice article SMW- many thanks!