Impact of moderate hyperbilirubinemia on the neuromotor trajectory of term infants: A General Movements Assessment study
Early Human Development, cilt.221, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 221
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.earlhumdev.2026.106626
- Dergi Adı: Early Human Development
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CINAHL, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO)
- Anahtar Kelimeler: General Movements Assessment, Neonatal hyperbilirubinemia, Neuromotor development, Phototherapy, Poor repertoire, Fidgety movements, Bilirubin-induced neurologic dysfunction
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: The neurodevelopmental impact of moderate neonatal hyperbilirubinemia remains a clinical grey area. Prechtl's General Movements Assessment (GMA) is a highly sensitive tool for monitoring early motor quality, but its utility in this intermediate-risk population is understudied. This study aimed to evaluate whether term infants with phototherapy-treated moderate hyperbilirubinemia exhibit altered spontaneous motor repertoires during the writhing and fidgety movement periods. Methods: In this prospective longitudinal cohort study, forty-two term infants (≥ 37 weeks' gestation) were divided into two groups: Group I (n = 21) received phototherapy for hyperbilirubinemia according to guidelines; Group II (n = 21) consisted of healthy term controls. Spontaneous motor patterns were independently evaluated using standardized GMA at 2 months (writhing period) and 4 months (fidgety period) by certified assessors blinded to clinical histories. Results: At 2 months, abnormal movement patterns, predominantly poor repertoire, were significantly more frequent in the hyperbilirubinemia group than in controls (57.1% vs. 19.0%; p = 0.012). At 4 months, although the statistical significance narrowed (p = 0.095), the prevalence of abnormal fidgety movements remained three times higher in Group I (35.3%) than in Group II (10.5%). No absent fidgety patterns were recorded. Conclusions: Term neonates requiring phototherapy for moderate hyperbilirubinemia demonstrate a higher prevalence of transient neuromotor alterations at 2 months. These findings support the clinical integration of serial GMA to ensure early neurodevelopmental surveillance for this frequently overlooked intermediate-risk cohort.