Neonatal hyperbilirubinemia and bilirubin induced neurologic dysfunction (BIND)

Extreme neonatal hyperbilirubinemia has largely decreased in the last decades, but moderate hyperbilirubinemia, which may cause subtle bilirubin-induced neurological dysfunction (BIND), is much more prevalent and of concern. More evidence is needed to be able to improve prevention. We will use data on clinical measurements of bilirubin in neonates born in two regions in Denmark (1997-2016) and estimate the association between hyperbilirubinemia and BIND outcomes: 1) developmental milestones in early life, 2) neurologic or neuropsychiatric disorders including autism spectrum disorder (ASD), cerebral palsy, attention deficit hyperactivity disorder (ADHD), auditory neuropathic disorder, epilepsy, and mental retardation, and 3) school performance. We will explore potential dose-response effects in these associations. Furthermore, we will apply a regression discontinuity (RD) design, which is a quasi-experimental study design allowing for rigorous causal inference, to estimate the causal treatment effect of phototherapy in preventing BIND in children with hyperbilirubinemia.