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Effect of phototherapy for neonatal jaundice on cognitive performance
D S Seidman1, I Paz, D K Stevenson
1Department of Pediatrics, Stanford University School of Medicine, Calif.
Insights
Phototherapy for neonatal hyperbilirubinemia did not impact cognitive outcomes in adolescence. This study found no beneficial or adverse effects on intelligence quotient scores in treated individuals compared to controls.
Area of Science:
- Neonatal Medicine
- Developmental Psychology
- Pediatric Neurology
Background:
- Neonatal hyperbilirubinemia is a common condition in newborns.
- Phototherapy was introduced in 1971 as a treatment for neonatal jaundice.
- Concerns exist regarding potential long-term neurodevelopmental effects of neonatal treatments.
Purpose of the Study:
- To evaluate the long-term cognitive outcomes of phototherapy for neonatal hyperbilirubinemia.
- To determine if phototherapy influences intelligence quotient (IQ) scores at 17 years of age.
- To assess the independent effect of phototherapy on cognitive development, controlling for confounding factors.
Main Methods:
- A cohort study comparing subjects born before and after the introduction of phototherapy in 1971.
- Intelligence test scores at 17 years of age were compared between phototherapy-treated subjects and matched controls.
- Multiple logistic regression analysis using General Linear Models was employed to adjust for perinatal and demographic factors.
Main Results:
- The mean IQ score at 17 years was 108 +/- 2 for phototherapy-treated subjects and 107 +/- 2 for controls.
- No statistically significant independent effect of phototherapy on IQ scores was observed after adjusting for confounding variables.
- Perinatal factors and demographic characteristics did not alter the lack of association between phototherapy and cognitive outcome.
Conclusions:
- Phototherapy for neonatal hyperbilirubinemia in full-term infants has no discernible beneficial or adverse effect on intellectual ability in late adolescence.
- The findings suggest that phototherapy is a safe treatment concerning long-term cognitive development.
- Further research may explore other neurodevelopmental outcomes beyond IQ scores.
Abstract:
Phototherapy for neonatal hyperbilirubinemia was introduced to our medical center in March 1971. To assess the influence of phototherapy on subsequent cognitive outcome, we compared the intelligence test scores at 17 years of age of subjects born 4 months before and 10 months after the introduction of phototherapy. The intelligence quotient score (mean +/- SE) at 17 years for 84 subjects with severe neonatal hyperbilirubinemia was 108 +/- 2 for those treated by phototherapy and 107 +/- 2 for controls matched for gestational age and birth weight. The confounding effect on intelligence quotient scores of perinatal factors (bilirubin concentrations, gestational age, birth weight, Apgar score) and demographic characteristics (ethnic origin, socioeconomic status, paternal education) was taken into account in a multiple logistic regression analysis by using a General Linear Models procedure. Phototherapy was found to have no independent effect on intelligence quotient scores after adjustment for the effect of confounding factors. We conclude that for full-term newborn infants with neonatal hyperbilirubinemia, phototherapy had neither a beneficial nor an adverse effect on intellectual ability in late adolescence.