NEUROLOGICAL OUTCOMES OF PROLONGED NEONATALJAUNDICE IN FULL-TERM INFANTS IN ALMATY CITY

Abstract

Introduction. One of the criteria for the transition of neonatal yellow sickness into a pathological condition is a duration
of more than 14 days of life. Many researchers note an increase in neonatal yellow sickness and possible complications of
the central nervous system in the form of child’s cerebral palsy, neuro-sensory hearing loss and behavioral disorders. The
debut of diseases is possible from the neonatal period, and at an older age it significantly reduces the quality of human life.
Purpose: To study the psychomotor disorders in infants who have had prolonged neonatal yellow sickness, using the
example of the neurological department of an early age of Children's City Clinical Hospital (CCCH) No. 2 in Almaty city.
Materials and research methods: In the materials of this study, a retrospective control analysis of 160 clinical records
of full-term infants who were hospitalized in the neurological department of an early age of Children's City Clinical Hospital
No. 2 in Almaty city since January 2016 to December 2018 was carried out. Criteria for inclusion of case in the group: fullterm, resident of Almaty, age at the time of hospitalization from 0 to 12 months, the fact of prolonged yellow sickness and the
level of total serum bilirubin > 85 μmol / L. Criteria for exclusion of case from the group: prematurity, absence of neonatal
yellow sickness, total serum bilirubin < 85 μmol / L, a villager. Criteria for inclusion to the control group: full-term, resident of
Almaty, age at the time of hospitalization from 0 to 12 months, lack of fact of transferred neonatal jaundice. Criteria for
exclusion from the control group: prematurity, the presence of neonatal yellow sickness, a villager.
Results: The Mann-Whitney test between the case and control groups showed a difference only in age p = 0.018, which
is associated with an earlier debut of neurological disorders in the case group. Statistically significant differences were found
by the risk factors for the burden of antenatal history using the Chi-square criterion p-0,000; the following risk factors for the
development of hyperbilirubinemia were established as statistically significant: incompatibility in the ABO group or Rh factor
(p-0.039), delivery by caesarean section (p-0.029). Children from the case group were more likely to be hospitalized in the
first three months of life (p-0,000), dyskinetic syndrome predominated in the clinic (p-0.002), they were more often diagnosed
with cerebral palsy (p-0.006), and there were impaired cerebrospinal fluid dynamics according to computer and magnetic
resonance imaging (p-0.006), according to routine electroencephalography there was a delay in the formation of bioelectric
activity of the brain (p-0.004).
Conclusions: Neurological outcomes of protracted neonatal yellow sickness in full-term infants are presented by
cerebral palsy, motor impairment in the form of a dyskinetic syndrome, pathological changes according to instrumental
diagnostic methods (neurosonography, electroencephalography and computed or magnetic resonance imaging), which
require further monitoring by a pediatric neurologist for long-term consequences in the second half of the first year of life and
at an older age.