Demonstration of neurological damage, oxidative damage and dna damage in newborns with hyperbilirubinemia

OBJECTIVE: Hyperbilirubinemia affects 60% of term babies and 80% of preterm babies. Although the height of bilirubin usually regresses spontaneously, it increases to levels that require phototherapy and exchange transfusion in some newborns and even causes irreversible damage in some newborns. Bilirubin elevation and phototherapy are thought to cause oxidative, neurological, and DNA damage. The aim of this study is to show the effect of high bilirubin and phototherapy on oxidative, neurological and DNA damage, to predict the complications that may occur in case of possible damage and to evaluate the use of biomarkers showing neurological damage instead of neuroimaging methods. MATERIAL/METHODS: Newborns without pathological hyperbilirubinemia and newborns with pathological hyperbilirubinemia and receiving phototherapy who admitted University of Manisa Celal Bayar, Faculty of Medicine, Department of Neonatalogy were included in the study between November 2020 and April 2021. While newborns with and without pathological hyperbilirubinemia were compared in terms of oxidative, neurological and DNA damage, newborns with pathological hyperbilirubinemia were compared in terms of oxidative, neurological and DNA damage before and after phototherapy. All statistical analyzes were made using the SPSS 23.0 package program. RESULTS: 60 newborns in the control group and 60 in the patient group were included in the study. Ten newborns from the patient group were excluded from the study due to hemolyzed sample. When the control group and the patient group before phototherapy were compared, total bilirubin, TOS, TAS, UCH-L1 levels were found to be significantly higher in the patient group before phototherapy (p <0.001). There was no statistically significant difference between NSE and 8-OHdG levels (p> 0.05). When the patient group was compared before and after phototherapy, total bilirubin, TOS, TAS, NSE levels were found to be significantly higher in the group before phototherapy (p<0.05). There was no statistically significant difference between 8-OHdG and UCH-L1 levels before and after phototherapy (p> 0.05). When the control group and the patient group after phototherapy were compared, total bilirubin, TOS, TAS, UCH-L1 levels were found to be significantly higher in the patient group after phototherapy (p <0.05). However, no statistically significant difference was found between 8-OHdG and NSE levels between these two groups (p> 0.05). When the group was compared after single and intensive phototherapy, a statistically significant difference was found between TOS levels (p = 0.008). When patients with abnormal BIND scores were compared with patients with normal BIND scores, a significant difference was found between total bilirubin and TAS levels (p <0.05). ROC analysis was performed for the diagnostic value of UCH-L1, which had a statistically significant difference between the control group and the patient group before and after phototherapy. The level of diagnostic value for UCH-L1 was 97.95 pg / ml. The sensitivity of 97.95 pg / ml was 80%, specificity 70%, negative predictive value 80.7% and positive predictive value 68.9%. CONCLUSION: In this study, it was shown that the high level of bilirubin in the neonatal period increased oxidative damage, did not have a significant effect on DNA damage, and significantly increased the level of UCH-L1, which indicates neurological damage. Phototherapy was shown to reduce oxidative damage, had no significant effect on DNA damage, and had no significant effect on NSE level indicating neurological damage.