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Cohort study
Need remains for evidence-based reassurance for absence of bilirubin neurotoxicity with severe hyperbilirubinaemia
  1. Vinod K Bhutani
  1. Department of Pediatrics, Stanford University, Palo Alto, California, USA
  1. Correspondence to : Professor Vinod K Bhutani
    Department of Pediatrics, Stanford University, 750 Welch Rd, #315, Palo Alto, CA 94304, USA; bhutani{at}

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Bilirubin-induced neurological dysfunction and its contextual relationship to severity of neonatal hyperbilirubinaemia has been a subject of long-standing debate. Vandborg and colleagues report no evidence of developmental delay, using a parent-centred ‘Ages and Stages Questionnaire’ (ASQ) survey, for a specific cohort of children (age 1 and 5 years) with antecedent severe hyperbilirubinaemia.


This was a controlled descriptive follow-up of 250 047 live-births in Denmark (2004–2007) that is linked through national registries to medical laboratory databases. The review identified 258 infants with severe hyperbilirubinaemia which was defined as at least one measure of total serum bilirubin (TSB) level ≥25 mg/dl (428 μmol/l) during the first 3 weeks after birth. The ASQ method evaluated child development and performance …

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  • Competing interests None.