Analysis of Factors Related To Head MRI Changes In Neonatal Hyperbilirubinemia And Effect On Neurodevelopmental Outcomes.

Background: and Objective This study aims to detect how hyperbilirubinemia affects cerebral structures by imagery (MRI) to prevent irreversible future brain damage. Research Design and Methods In this retrospective study, 50 infants of 35 weeks gestation or more with hyperbilirubinemia were assigned to two groups based on abnormal or normal head imaging (MRI). The primary outcomes included peak bilirubin levels according to socio-demographic factors and how these levels influence MRI.The secondary outcome was neurodevelopment at 1, 3, 6, 9 and 12 months for the imaging changes versus the normal imaging groups assessed by a combined formulaire based on the CDC’s developmental milestones, the Denver II Developmental Screening Test (DDST), the Hammersmith infant neurological exam, and auditory brainstem response (ABR) by investigators. Results: Peak serum bilirubin levels (TSB) in the group with MRI changes, defined as bilaterally symmetrical signal intensity on T1- weighted imaging in the globus pallidus GP, was significantly higher than those in the group without MRI changes (342.5±47.6μmol/L vs. 284.3±46.3μmol/L), p=0.000. Odds ratios when observing TSB values with 342μmol/L as cut-off, showed that participants with TSB ≥ 342μmol/L were 12.4 times more likely of presenting with abnormal MR imaging (OR=12.4, 95% CI 2.191-70.672). In addition, a cross-tab comparison between MRI and milestones depicts MRI as having a 66.7% ，33.3% sensitivity and specificity while 12.5%，97.1% PPV (positive predictive value) and NPV (negative predictive values) respectively for milestone attainment. No relationship was found between abnormal outcomes and abnormal MRI. Conclusions: A significant relationship between high bilirubin levels and head imaging (MRI) was observed, but these changes in imaging could not significantly predict neurodevelopmental outcomes.