Acta Scientific PAEDIATRICS (ISSN: 2581-883X)

Research Article Volume 6 Issue 3

Effects of TSB Levels above 5mg/dl on Primitive Reflex Responses and Righting Reactions in Preterm Newborns

Maria do Céu Pereira Gonçalves1*, Giovanna Marcella Cavalcante Carvalho2 and Márcia Gonçalves Ribeiro3

1Department of Physiotherapy at Estácio de Sá University, Rio de Janeiro; Division of Physiotherapy in Infant Health at the Petrópolis Municipal Health Foundation; Neonatal Intensive Care Unit at Alcides Carneiro Teaching Hospital, Petrópolis, Rio de Janeiro, Brazil
2Pedro Ernesto University, State University of Rio de Janeiro, Brazil
3Pediatrics Division, Faculty of Medicine, Federal University of Rio de Janeiro, Brazil

*Corresponding Author: Maria do Céu Pereira Gonçalves, Department of Physiotherapy at Estácio de Sá University, Rio de Janeiro; Division of Physiotherapy in Infant Health at the Petrópolis Municipal Health Foundation; Neonatal Intensive Care Unit at Alcides Carneiro Teaching hospital, Petrópolis, Rio de Janeiro, Brazil.

Received: January 20, 2023; Published: February 28, 2023

Abstract

Objective: to identify the mean total serum bilirubin (TSB) level in preterm newborns with abnormal primitive reflex responses at corrected age (CA) of one month; to determine whether there is an association between TSB levels and abnormal primitive reflex responses and righting reactions; and to investigate the influence of phototherapy on primitive reflexes.

Design: we conducted a prospective cohort study with 10-week follow-up.

Settings: intermediate care and rooming-in units at a teaching hospital, and maternity clinic in Petrópolis, Rio de Janeiro, Brazil.

Patients: sample of 343 infants with gestational age below 36 weeks, five-minute Apgar score of ≥ 7, and no history of intraventricular hemorrhage detected using transfontanelle ultrasound performed up to corrected gestational age (CGA) of 40 weeks.

Main outcome measures: assessment of primitive reflexes and righting reactions at CGA of 35 weeks; physical examination using the Dubowitz examination ("The Neurological Assessment of the Preterm and Full-term Newborn Infant"); retest of primitive reflexes and righting reactions at CA of one month on infants weighing ≥ 2500g on the day of the test.

Results: mean birth weight and TSB were 1814g ± 465g and 8.3 ± 2.7mg/dL (5.6 - 23.8mg/dL), respectively, in the abnormal response group, compared to 2152g ± 525g and 6.2 ± 3.8mg/dL (1.8 - 18mg/dL), respectively, in the normal response group. Phototherapy was used on 67.9% of the infants in the abnormal response group, compared to 24.1% in the normal response group. The findings reveal that infants who underwent phototherapy with TSB > 8.3mg/dL showed the following abnormal primitive reflex responses and righting reactions: palmar grasp, plantar support, sucking, Babkin, Moro, neck righting, and labyrinthine righting, as well as asymmetrical tonic neck reflex and tonic labyrinthine reflex, both of which are pathological reflexes.

Conclusion: infants with TSB > 8.3 ± 2.7mg/dL showed abnormal primitive reflexes and righting reactions, despite undergoing phototherapy.

Keywords: Primitive Reflex; Hyperbilirubinemia; Kernicterus; Bilirubin Encephalopathy

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Citation

Citation: Maria do Céu Pereira Gonçalves.,et al. “Effects of TSB Levels above 5mg/dl on Primitive Reflex Responses and Righting Reactions in Preterm Newborns". Acta Scientific Paediatrics 6.3 (2023): 21-27.

Copyright

Copyright: © 2023 Maria do Céu Pereira Gonçalves., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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