LONG-TERM FOLLOW-UP OF INDIRECT HYPERBILIRABINEMIA IN FULL-TERM TURKISH INFANTS

objective. This retrospective follow-up study was performed to evaluat e the suitability of the recently reported exchange transfusion limits (serum indirect bilirubin level of 428-496 mu mol/l, 25-29 mg/dl) for Turkey. Material and methods: The study groups totalled 102 children, 8-13 years of age, who had been born at term with birthweights greate r than 3000 g and had been treated for indirect hyperbilirubinemia dur ing their newborn period: the control group consisted of 27 children o f the same age-group without indirect hyperbilirubinemia. Children wer e grouped according to their maximum serum indirect bilirubin levels a nd direct Coombs' test results. Physical and neurological examinations , visual and brainstem auditory evoked potentials and the Wechsler Int elligence Scale for Children-Revised for Turkish Children were perform ed. Results: There was no difference between the groups with regard io mean visual and brainstem auditory evoked potential latencies. Childr en whose direct Coombs' tests were positive had significantly lower IQ scores and more prominent neurological abnormalities (p < 0.05). IQ s cores and prominent neurological abnormalities did not differ among th e other groups. Nine children had prominent neurological abnormalities associated with abnormal brainstem auditory evoked potentials. An imp ortant risk factor was the duration that the infant's serum indirect b ilirubin level remained greater than 342 mu mol/l (20 mg/dl). Conclusi on: The current limit of 342 mu mol/l should continue to be used for i nfants whose direct Coombs' tests are positive in our country. Until b etter criteria for exchange transfusion other than the indirect biliru bin level are established, the current limits should also still be fol lowed for infants whose direct Coombs' tests are negative in Turkey, w here regular neonatal follow-up examinations are not satisfactory.