Are Neuron Specific Enolase and S100B Levels associated with the Neurodevelopmental Prognosis of Newborns with Indirect Hyperbilurubinemia?

Introduction: Billirubin induced neurologic dysfunction (BIND) is determined by acute and chronic clinical symptoms, but at which level neurotoxicity starts is still unknown. Our aim in this study was to test serum markers S100B and NSE in newborns with jaundice, to determine their development by the Bayley scores of infant development( BSID) and to detect the relation between early neurodevelopmental prognosis with these markers.

Material and Methods: This prospective controlled study was performed with 50 early term and term neonates. The study group included 30 term neonates who were admitted to our hospital because of jaundice within the 7 days postnatally. They were applied phototerapy due to high bilirubin levels. The control group included 20 term healthy neonates except physiologic jaundice. The levels of S100B, NSE, total serum bilirubin were determined. Their developments were evaluated at 9-12 months of age and the Bayley scores of infant development were determined.

Results: The mean level of total serum bilirubin on admission in the study group was 19,9 ± 3,5 mg/dL, and the level declined to 9,5 ± 2,1 mg/dL following phototerapy (p<0,001). The levels of NSE and S100B were not statistically different before and after phototerapy. The infant`s Bayley scores for study and control groups were not statistically different. We determined positive relation between language scores and S100B levels in the control group. There were also significant positive relation between paternal education and language scores. We determined that S100B and NSE statistically insignificant to determine success of phototherapy requirement while total serum bilirubin statistically significant on this issue.

Conclusion: S100B and NSE levels were not found to be associated with neurodevelopmental findings in the current study. To determine the predictions of neurodevelopmental prognosis of S100B and NSE in neonatal hyperbilirubinemia, studies with higher serum bilirubin level and number of patients are needed.