The Relationship Between B/A Ration And ABR, And The Significance Of B/A Ratio In Predicting Bilirubin Encephalopathy

Objective The management of non-hemolytic hyperbilirub-inemia of term newborns is controversial. In order to evaluate the value of the bilirubin/albumin(B/A) ratio in the management of hyperbilirubinemia, we compared it with abnormal auditory brainstem responses(ABRs).Methods ABRs and B/A ratio in 43 term newborns with hyperbilirubinemic [total bilirubin concentrations(TBCs)>300^mo l/l and direct bilirubin/TBCs<0.02]were measured before treatment. They were divided into three groups according to the results of ABR: group A(n=25) with normal ABR, group B (n=8) with poor amplitude of wavel or wavelll or waveV, and group C(n=10) with two or more abnormal index as follow [prolonged latency of wave PL and IPL, decreased ratio of V/I or poor amplitude].Results The peak TBC was significantly different between groups A and C(19.6 ± 1.7 mg/dl and 22.8 ± 3. Img/dl, respectively; P<0. 05) , and between groups B and C(19.4± 1. 4mg/dl and22.8±3. Img/dl, respectively; P<0. 05) ; though there were no differences between groups A and B. The peak B/A ratio in group C[(6.21±0. 41) X 10"3]was significantly higherthan that of groups A[ (5.55±0. 45) X 10-5 ( P<0.01)and B [(5.33±0.68) X 10"3]( P<0.01), though no significant differences was noticed between groups A and B. Abnormal ABR findings were closely associated with the B/A ratio by multiple logistic regression analysis(P<0.05).Conclusion These results suggested that it was bettr than TBC for the B/A ratio to evaluate the possible risk of bilirubin cncephalopathy in full-term riewborns. Abnormal ABR findings were closely associated with the B/A ratio . Treatment will be used for the neonate with non-hemolytic llyperbilirubinemia when theirs B/A ratio > 5.0 X 10~3.