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The behavior of jaundiced infants treated with phototherapy
Insights
Phototherapy for infant jaundice may affect infant behavior, particularly visual orientation. Treated infants showed poorer performance on behavioral assessments compared to controls, with some effects persisting at one month.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Behavioral Pediatrics
Background:
- Hyperbilirubinemia (jaundice) is common in newborns.
- Phototherapy is a standard treatment for neonatal jaundice.
- Potential neurobehavioral effects of phototherapy require investigation.
Purpose of the Study:
- To evaluate behavioral changes in jaundiced infants treated with phototherapy.
- To compare the behavior of treated infants with a control group.
Main Methods:
- Thirty jaundiced infants treated with phototherapy were assessed using the Brazelton Neonatal Behavior Assessment Scale (BNBAS).
- A control group of 30 non-jaundiced infants was matched for key demographic and clinical factors.
- Behavioral assessments were conducted on the 3rd day, 4th day, and at one month of age.
Main Results:
- Infants receiving phototherapy demonstrated significantly poorer performance in several BNBAS items, including visual orientation, compared to controls.
- These deficits, particularly in visual orientation, were observed shortly after phototherapy and persisted at one month of age.
- Six specific behavioral items showed statistically significant differences between the phototherapy and control groups.
Conclusions:
- Phototherapy for neonatal hyperbilirubinemia may be associated with transient neurobehavioral changes.
- Visual orientation responses appear to be the most affected behavioral domain.
- Further research is needed to determine if observed effects are due to jaundice itself or the phototherapy treatment.
Abstract:
This study was performed in order to evaluate possible changes in behavior in jaundiced infants without perinatal complications other than hyperbilirubinemia treated with phototherapy. Thirty jaundiced infants (mean bilirubinemia 13.3 mg/100 ml, range 8.4-17.5) born spontaneously at term and undergoing phototherapy for 6 h or more, and 30 comparison subjects similar for sex, birthweight, gestational age, Apgar score, obstetrical history and father's profession were examined during the 3rd day of life according to Brazelton Neonatal Behavior Assessment Scale (BNBAS). For 6 of 26 items we found higher values for comparison group (Wilcoxon's Test): inanimate visual median (m.) 5 vs. 3 (P less than 0.05); animate visual m. 5 vs. 3.5 (P less than 0.01); visual and auditory 5.5 vs. 4 (P less than 0.005); pull-to-sit m. 6 vs. 5 (P less than 0.01); cuddliness m. 5 vs. 4 (P less than 0.01); alertness m. 5 vs. 4 (P less than 0.005). Visual orientation responses were the most compromised. On the 4th day of life, 14 infants who had terminated phototherapy at least 2 h before (mean 9.9 h) were compared with their matched comparison group subjects and the same significantly poorer performances, mainly in visual orientation, were found. At one month of age, 12 of these infants treated with phototherapy still showed a significantly poorer performance in 2 items of orientation: inanimate visual m. 6 vs. 4.5 (P less than 0.05); visual and auditory m. 6.5 vs. 4 (P less than 0.05). Whether these results depend on the jaundice or on the phototherapy remain to be established.