Intelligence at six years in relation to neonatal bilirubin level : follow-up of the National Institute of Child Health and Human Development Clinical Trial of Phototherapy
Results of the National Institute of Child Health and Human Development Randomized Controlled Trial of Phototherapy were examined for the relationship of neonatal bilirubin level to neurological and developmental outcome at 6-year follow-up. This analysis focused on 224 control children with birth w...
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Veröffentlicht in: | Pediatrics (Evanston) 1991-06, Vol.87 (6), p.797-805 |
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description | Results of the National Institute of Child Health and Human Development Randomized Controlled Trial of Phototherapy were examined for the relationship of neonatal bilirubin level to neurological and developmental outcome at 6-year follow-up. This analysis focused on 224 control children with birth weight of less than 2000 g. Bilirubin levels were maintained below previously specified levels by the use of exchange transfusion only (24%). Rates of cerebral palsy were not significantly higher for children with elevated maximum bilirubin level than for those whose level remained low. No association was evident between maximum bilirubin level and IQ (Full Scale, Verbal, or Performance) by simple correlation analysis (r = -.087, P = .2 for Full Scale) or by multiple linear regression adjusting for factors that covary with IQ (β = -.15, P = .58). IQ was not associated with mean bilirubin level, time and duration of exposure to bilirubin, or measures of bilirubin-albumin binding. Thus, over the range of bilirubin levels permitted in this clinical trial, there was no evidence of bilirubin toxicity to the central nervous system. Measures used to control the level of bilirubin in low birth weight neonates appear to prevent effectively the risk of bilirubin-induced neurotoxicity. |
doi_str_mv | 10.1542/peds.87.6.797 |
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C ; GRAUBARD, B. I ; NELSON, K. B ; HIRTZ, D. G ; HOFFMAN, H. J ; GARTNER, L. M ; BRYLA, D. A</creator><creatorcontrib>SCHEIDT, P. C ; GRAUBARD, B. I ; NELSON, K. B ; HIRTZ, D. G ; HOFFMAN, H. J ; GARTNER, L. M ; BRYLA, D. A</creatorcontrib><description>Results of the National Institute of Child Health and Human Development Randomized Controlled Trial of Phototherapy were examined for the relationship of neonatal bilirubin level to neurological and developmental outcome at 6-year follow-up. This analysis focused on 224 control children with birth weight of less than 2000 g. Bilirubin levels were maintained below previously specified levels by the use of exchange transfusion only (24%). Rates of cerebral palsy were not significantly higher for children with elevated maximum bilirubin level than for those whose level remained low. No association was evident between maximum bilirubin level and IQ (Full Scale, Verbal, or Performance) by simple correlation analysis (r = -.087, P = .2 for Full Scale) or by multiple linear regression adjusting for factors that covary with IQ (β = -.15, P = .58). IQ was not associated with mean bilirubin level, time and duration of exposure to bilirubin, or measures of bilirubin-albumin binding. Thus, over the range of bilirubin levels permitted in this clinical trial, there was no evidence of bilirubin toxicity to the central nervous system. Measures used to control the level of bilirubin in low birth weight neonates appear to prevent effectively the risk of bilirubin-induced neurotoxicity.</description><identifier>ISSN: 0031-4005</identifier><identifier>EISSN: 1098-4275</identifier><identifier>DOI: 10.1542/peds.87.6.797</identifier><identifier>CODEN: PEDIAU</identifier><language>eng</language><publisher>Elk Grove Village, IL: American Academy of Pediatrics</publisher><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Bilirubin ; Biological and medical sciences ; Care and treatment ; Child development ; Emergency and intensive care: neonates and children. Prematurity. 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Rates of cerebral palsy were not significantly higher for children with elevated maximum bilirubin level than for those whose level remained low. No association was evident between maximum bilirubin level and IQ (Full Scale, Verbal, or Performance) by simple correlation analysis (r = -.087, P = .2 for Full Scale) or by multiple linear regression adjusting for factors that covary with IQ (β = -.15, P = .58). IQ was not associated with mean bilirubin level, time and duration of exposure to bilirubin, or measures of bilirubin-albumin binding. Thus, over the range of bilirubin levels permitted in this clinical trial, there was no evidence of bilirubin toxicity to the central nervous system. Measures used to control the level of bilirubin in low birth weight neonates appear to prevent effectively the risk of bilirubin-induced neurotoxicity.</description><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Bilirubin</subject><subject>Biological and medical sciences</subject><subject>Care and treatment</subject><subject>Child development</subject><subject>Emergency and intensive care: neonates and children. Prematurity. Sudden death</subject><subject>Evaluation</subject><subject>Hyperbilirubinemia</subject><subject>Intellect</subject><subject>Intelligence (Psychology)</subject><subject>Intensive care medicine</subject><subject>Medical sciences</subject><subject>Neonatal jaundice</subject><subject>Phototherapy</subject><subject>Physiological aspects</subject><issn>0031-4005</issn><issn>1098-4275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1991</creationdate><recordtype>article</recordtype><recordid>eNpFkUFv1DAQhaMKpC6FI3dfuJGt7SR2wq0Kha5UUQ7t2Zo4410jrx3ZXtr9T_zIelkkLh5L8703mnlV9ZHRNetafr3gnNa9XIu1HORFtWJ06OuWy-5NtaK0YXVLaXdZvUvpF6W07SRfVX82PqNzdoteI4FMkn0hR4SYiPUkooNsgyc5EI_BQwZHJutsPEyl7fA3OvKFmOBceK4PCwmG5B2SH39Vhd34lG0-ZDx1xp11M7lDcHlHwJfvYQ-efD25hGWPPpPRWW91ET5GW94i-rkLORTPCMvxffXWgEv44V-9qp6-3T6Od_X9w_fNeHNfa85krjuBEsXccNZKybu24XzuqTTt1E9yYKgRBgqAjEtdUG6kaQSfzNxBL0wPzVX1-ey7BYfKeh3KkV6yLmviFlWZNT6oG8ZYMzQtLXh9xnUMKUU0aol2D_GoGFWnZNQpGdVLJVRJpvCfzvwCqexqInht03_RIIXkQjSv6lqRvw</recordid><startdate>19910601</startdate><enddate>19910601</enddate><creator>SCHEIDT, P. 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Cell therapy and gene therapy</topic><topic>Bilirubin</topic><topic>Biological and medical sciences</topic><topic>Care and treatment</topic><topic>Child development</topic><topic>Emergency and intensive care: neonates and children. Prematurity. Sudden death</topic><topic>Evaluation</topic><topic>Hyperbilirubinemia</topic><topic>Intellect</topic><topic>Intelligence (Psychology)</topic><topic>Intensive care medicine</topic><topic>Medical sciences</topic><topic>Neonatal jaundice</topic><topic>Phototherapy</topic><topic>Physiological aspects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SCHEIDT, P. C</creatorcontrib><creatorcontrib>GRAUBARD, B. I</creatorcontrib><creatorcontrib>NELSON, K. B</creatorcontrib><creatorcontrib>HIRTZ, D. G</creatorcontrib><creatorcontrib>HOFFMAN, H. J</creatorcontrib><creatorcontrib>GARTNER, L. M</creatorcontrib><creatorcontrib>BRYLA, D. 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A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intelligence at six years in relation to neonatal bilirubin level : follow-up of the National Institute of Child Health and Human Development Clinical Trial of Phototherapy</atitle><jtitle>Pediatrics (Evanston)</jtitle><addtitle>Pediatrics</addtitle><date>1991-06-01</date><risdate>1991</risdate><volume>87</volume><issue>6</issue><spage>797</spage><epage>805</epage><pages>797-805</pages><issn>0031-4005</issn><eissn>1098-4275</eissn><coden>PEDIAU</coden><abstract>Results of the National Institute of Child Health and Human Development Randomized Controlled Trial of Phototherapy were examined for the relationship of neonatal bilirubin level to neurological and developmental outcome at 6-year follow-up. This analysis focused on 224 control children with birth weight of less than 2000 g. Bilirubin levels were maintained below previously specified levels by the use of exchange transfusion only (24%). Rates of cerebral palsy were not significantly higher for children with elevated maximum bilirubin level than for those whose level remained low. No association was evident between maximum bilirubin level and IQ (Full Scale, Verbal, or Performance) by simple correlation analysis (r = -.087, P = .2 for Full Scale) or by multiple linear regression adjusting for factors that covary with IQ (β = -.15, P = .58). IQ was not associated with mean bilirubin level, time and duration of exposure to bilirubin, or measures of bilirubin-albumin binding. Thus, over the range of bilirubin levels permitted in this clinical trial, there was no evidence of bilirubin toxicity to the central nervous system. Measures used to control the level of bilirubin in low birth weight neonates appear to prevent effectively the risk of bilirubin-induced neurotoxicity.</abstract><cop>Elk Grove Village, IL</cop><pub>American Academy of Pediatrics</pub><doi>10.1542/peds.87.6.797</doi><tpages>9</tpages></addata></record> |
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subjects | Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Bilirubin Biological and medical sciences Care and treatment Child development Emergency and intensive care: neonates and children. Prematurity. Sudden death Evaluation Hyperbilirubinemia Intellect Intelligence (Psychology) Intensive care medicine Medical sciences Neonatal jaundice Phototherapy Physiological aspects |
title | Intelligence at six years in relation to neonatal bilirubin level : follow-up of the National Institute of Child Health and Human Development Clinical Trial of Phototherapy |
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