The effect of intestinal flora on the neural development of severe hyperbilirubinemia neonates

N. Yang, R.-X. Yang, A.-H. Wang, Y.-Q. Zhang

Department of Pediatric, Dezhou People’s Hospital, Dezhou, P.R. China. nq34vg@163.com

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• Gastroenterology

OBJECTIVE: To investigate the effect of intestinal flora on the neural development of severe hyperbilirubinemia neonates.

PATIENTS AND METHODS: The clinical data of 108 severe hyperbilirubinemia neonates admitted to the Dezhou People’s Hospital from January 2015 through January 2018 were analyzed, and all newborns had a serum total bilirubin level > 342 μmol/L. Based on whether they suffered from neural development abnormalities, the neonatal patients were divided into the neural abnormality group (n=52) and the non-neural abnormality group (n=56). The unconjugated bilirubin levels in serum and cerebrospinal fluid (CSF) and the composition of intestinal flora were compared.

RESULTS: Among 108 neonates, there were 55 cases with developmental abnormalities, in which 52 (48.13%) cases had neural developmental abnormalities, mainly epileptic patients. The serum and CSF unconjugated bilirubin levels of the neonatal patients in the neural abnormality group were (466.25±97.64) μmol/L and (9.64±2.98) μmol/L, respectively, which were higher than those in neonatal patients of the non-neural abnormality group [(357.89±72.53) μmol/L and (6.73±3.11) μmol/L], with statistically significant differences (p<0.05). The abundance of intestinal flora genus in the neonates in the neural abnormality group was lower than that in the non-neural abnormality group, and the comparisons of Fusobacterium, Catabacter, Succinivibrio, Clostridium and Bacteroides between the two groups showed statistically significant differences (p<0.05).

DISCUSSION: The intestinal micro-ecological environment of newborns was vulnerable and easily affected by many factors such as methods of delivery, feeding ways and eating habits of their mothers. This study investigated the effects of intestinal flora on the neural development of neonates with severe hyperbilirubinemia. The results showed that, due to decreased intestinal flora diversity, the serum and cerebrospinal fluid bilirubin levels were elevated, and the abnormal rate of neural development was increased.

CONCLUSIONS: Severe hyperbilirubinemia neonates with neural abnormalities have decreased diversity of intestinal flora genus and relatively high serum and CSF bilirubin levels, probably because the decrease in the diversity of intestinal flora genus leads to the change of the blood-CSF barrier permeability, leading to raised levels of bilirubin in serum and CSF, thus affecting the neural development of neonatal patients.

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