Abstract：
Accumulation of bilirubin above normal levels is considered a neurological risk factor for both premature and full-term newborns. This systematic review aimed to determine the effect of neonatal hyperbilirubinemia on neurodevelopment in preterm and full-term newborns.
PubMed, EMBASE, Cochrane Library, CINAHL, PsycINFO, Scopus and Lilacs databases were searched for articles published until 1 June 2022. The quality of cohort and case-control studies was assessed with the Newcastle-Ottawa Scale, and the MINCir scale was used to evaluate the methodological quality of therapy studies or the therapeutic procedures. Premature neonates without neurological conditions and those born at term with hyperbilirubinemia as the sole risk factor were included. Studies reporting one or more neurodevelopmental outcomes were included with an inter-group comparison of a hyperbilirubinemia group versus a non-hyperbilirubinemia or non-pathological hyperbilirubinemia group. The main outcomes were auditory function, visual function, cognitive function, motor function, behavior, global development and neurological risk.
The search identified 951 studies, 19 of which (n = 2210 newborns) were finally included. Fifteen of the cohort and case-control studies presented low risk of bias, and six studies showed high methodological quality. Within the preterm population, hyperbilirubinemia as the sole risk factor was not shown to affect neurodevelopment. Auditory, neurological and motor development alterations were found in the population of full-term newborns with hyperbilirubinemia, which were more evident during the first year of life.
Elevated bilirubin levels may be a trigger for the onset of neurodevelopmental disorders in full-term infants during the first year of life. More studies are warranted in the preterm population with hyperbilirubinemia to draw conclusions about its impact on their neurodevelopment.
PubMed, EMBASE, Cochrane Library, CINAHL, PsycINFO, Scopus and Lilacs databases were searched for articles published until 1 June 2022. The quality of cohort and case-control studies was assessed with the Newcastle-Ottawa Scale, and the MINCir scale was used to evaluate the methodological quality of therapy studies or the therapeutic procedures. Premature neonates without neurological conditions and those born at term with hyperbilirubinemia as the sole risk factor were included. Studies reporting one or more neurodevelopmental outcomes were included with an inter-group comparison of a hyperbilirubinemia group versus a non-hyperbilirubinemia or non-pathological hyperbilirubinemia group. The main outcomes were auditory function, visual function, cognitive function, motor function, behavior, global development and neurological risk.
The search identified 951 studies, 19 of which (n = 2210 newborns) were finally included. Fifteen of the cohort and case-control studies presented low risk of bias, and six studies showed high methodological quality. Within the preterm population, hyperbilirubinemia as the sole risk factor was not shown to affect neurodevelopment. Auditory, neurological and motor development alterations were found in the population of full-term newborns with hyperbilirubinemia, which were more evident during the first year of life.
Elevated bilirubin levels may be a trigger for the onset of neurodevelopmental disorders in full-term infants during the first year of life. More studies are warranted in the preterm population with hyperbilirubinemia to draw conclusions about its impact on their neurodevelopment.
摘要：
背景：胆红素高于正常水平的积累被认为是早产和足月新生儿的神经系统危险因素。本系统综述旨在确定新生儿高胆红素血症对早产和足月新生儿神经发育的影响。
方法：PubMed，EMBASE,科克伦图书馆,CINAHL,PsycINFO,搜索了Scopus和Lilacs数据库中直到2022年6月1日发表的文章。队列和病例对照研究的质量用纽卡斯尔-渥太华量表进行评估，MINCir量表用于评估治疗研究或治疗程序的方法学质量.包括没有神经系统疾病的早产儿和足月出生的高胆红素血症为唯一危险因素的新生儿。报告一种或多种神经发育结果的研究包括高胆红素血症组与非高胆红素血症或非病理性高胆红素血症组的组间比较。主要结果是听觉功能，视觉功能,认知功能,运动功能,行为，全球发展和神经系统风险。
结果：搜索确定了951项研究，其中19例（n=2210例新生儿）最终包括在内。15项队列和病例对照研究呈现低偏倚风险，六项研究显示了较高的方法学质量。在早产人群中，未显示高胆红素血症作为唯一的危险因素影响神经发育.听觉,在患有高胆红素血症的足月新生儿中发现了神经和运动发育改变，这在生命的第一年更加明显。
结论：胆红素水平升高可能是足月婴儿第一年神经发育障碍发作的触发因素。有必要在高胆红素血症的早产人群中进行更多的研究，以得出有关其对神经发育影响的结论。
方法：PubMed，EMBASE,科克伦图书馆,CINAHL,PsycINFO,搜索了Scopus和Lilacs数据库中直到2022年6月1日发表的文章。队列和病例对照研究的质量用纽卡斯尔-渥太华量表进行评估，MINCir量表用于评估治疗研究或治疗程序的方法学质量.包括没有神经系统疾病的早产儿和足月出生的高胆红素血症为唯一危险因素的新生儿。报告一种或多种神经发育结果的研究包括高胆红素血症组与非高胆红素血症或非病理性高胆红素血症组的组间比较。主要结果是听觉功能，视觉功能,认知功能,运动功能,行为，全球发展和神经系统风险。
结果：搜索确定了951项研究，其中19例（n=2210例新生儿）最终包括在内。15项队列和病例对照研究呈现低偏倚风险，六项研究显示了较高的方法学质量。在早产人群中，未显示高胆红素血症作为唯一的危险因素影响神经发育.听觉,在患有高胆红素血症的足月新生儿中发现了神经和运动发育改变，这在生命的第一年更加明显。
结论：胆红素水平升高可能是足月婴儿第一年神经发育障碍发作的触发因素。有必要在高胆红素血症的早产人群中进行更多的研究，以得出有关其对神经发育影响的结论。
