Prediction of bilirubin neurotoxicity in term newborns by biomarkers indicating brain injury

Our study aimed to evaluate whether there is any correlation between different bilirubin levels and biomarkers indicating neuronal damage, as well as between these different biomarkers themselves. The study was started after obtaining ethical approval with the reference 2022/05-08 dated 07.04.2022 from the Ethics Committee of Firat University Medical Faculty. The cases were divided into 5 groups according to bilirubin levels (G1≥25, G2=20.1-25, G3=15.1-20, G4=10.1-15, G5=5-10 mg/dL). S100B, tau, activin and adrenomedullin levels were measured from the peripheral blood samples obtained. The research was finished over a 12-month period. A total of 91 cases (n=27 girls, n=64 boys) were included in the study. In G1, a significant positive correlation was detected between bilirubin and adrenomedullin, activin, and tau; and adrenomedullin and tau, S100B (p<0.05). In G2, correlations were found between bilirubin and S100B; adrenomedullin and activin, tau, and S100B; activin and tau, and S100B; and tau and S100B (p<0.05). G3 displayed correlations between adrenomedullin and activin, tau, and S100B; activin and tau, and S100B; and tau and S100B (p<0.05). Group 4 found correlations between bilirubin and activin; adrenomedullin and activin, tau, and S100B; activin and tau, and S100B; and tau and S100B (p<0.05). In G5, correlations were observed between bilirubin and tau; adrenomedullin and activin; activin and S100B; and tau and S100B (p<0.05). Comparing the groups in terms of adrenomedullin, activin, tau, and S100B revealed statistically significant differences (p<0.05), which were identified to originate from the elevated values in G1. Upon evaluation without categorizing the patients, significant positive correlations were found between bilirubin, adrenomedullin, activin, tau, and S100B (p<0.05). The correlation between high bilirubin levels and biomarkers indicating brain damage may shed light on the early diagnosis and monitoring of bilirubin encephalopathy in newborn babies.