1 / 8

Neonatal Bilirubin Levels and Developmental Outcome

Neonatal Bilirubin Levels and Developmental Outcome. Dennis Odell Rachel Duchoslav Erin Clark Rena Vanzo Lisa Samson-Fang. Background. High bilirubin levels in neonates are known to be associated with kernicterus

Download Presentation

Neonatal Bilirubin Levels and Developmental Outcome

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Neonatal Bilirubin Levels and Developmental Outcome Dennis Odell Rachel Duchoslav Erin Clark Rena Vanzo Lisa Samson-Fang

  2. Background • High bilirubin levels in neonates are known to be associated with kernicterus • Multiple additional risk factors with high bilirubin levels increase risk of kernicterus • Tip of the iceberg? • Increased risk of autism/ADHD/LD with high bilirubin levels • Protocols are in place for measuring levels in all newborns

  3. Controversies • What is a safe bilirubin level?? • Very poor predictive validity • Natural biological mechanisms in place that keep bilirubin levels high • Do current treatments (phototherapy) actually prevents adverse outcomes? • Best best protocol to prevent kernicterus is uncertain • All newborns are screened to prevent very rare cases

  4. Research Questions • Is there increased risk of autism/ADHD/LD with high neonatal bilirubin levels? • Are there identifiable risk factors that increase the possibility of adverse outcomes? • Do current treatment regimens such as phototherapy decrease the risk of adverse outcomes? • Is bilirubin level over time a better predictor of outcome? • Is there any evidence of a protective effect of hyperbilirubinemia in neonates?

  5. Methods-pilot study • Identify children at USU clinic with a diagnosis of autism/ADHD/LD • Identify age/gender/ethnicity-matched healthy controls through the Budge Clinic (pediatrics) • Review clinic records, 0-3 developmental records, and IHC intermountain records and record on chart review form • Statistical analysis of data, particularly looking at bilirubin levels and developmental outcomes, as well as presence or absence of identifiable risk factors.

  6. Progress • Assembled team to do study, and developed research plan • Developed chart review form and patient identification protection protocols • Contacted different sites to determine accessibility of resources • Submitted proposal to IHC and USU IRBs • IRB approval obtained from both. • Consent forms (letter of information, opt out option)/protocols in place • Ready to proceed with data acquisition and analysis

  7. Future plans • Begin with 50-100 subjects and controls and complete data acquisition • Analyze data • Based on pilot data, consider large scale study utilizing IHC’s extensive database • Consider multiple other related questions, such as: • association with hearing loss • other developmental outcomes • improving accuracy of current protocols to prevent adverse outcomes

  8. URLEND 2010-2011 • Individual Leadership Project as a supplementary experience • Continue current group project format • Encourage identification of individual project opportunities during clinical rotations • Count toward clinical/research/leadership hours • Enrich the current URLEND experience • Facilitate the transition to leadership roles • Lead to projects with lasting community impact • Highlight URLEND capabilities

More Related