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Bilirubin-induced neurologic dysfunction (BIND) assessment (score) for term and late preterm infants

Bilirubin-induced neurologic dysfunction (BIND) assessment (score) for term and late preterm infants
Clinical signs Score
Mental status
Normal 0
Sleepy but arousable, decreased feeding 1
Lethargic, poor suck, irritable, and/or jittery 2
Semicomatose to comatose, unable to feed, seizures 3
Muscle tone
Normal 0
Persistent mild to moderate hypotonia 1
Mild to moderate hypertonia alternating with hypotonia 2
Persistent retrocollis and opisthotonos 3
Cry pattern
Normal 0
High pitched when aroused 1
Shrill, difficult to console 2
Inconsolable crying or weak/absent cry 3
Total BIND score  

Total scores for BIND determine the presence and severity of acute bilirubin encephalopathy (ABE) for newborns with hyperbilirubinemia without other identifiable causes for neurologic dysfunction.

Interpretation of the BIND score is as follows:
  • 1 to 3: Consistent with subtle signs of ABE
  • 4 to 6: Moderate ABE
  • 7 to 9: Advanced ABE
Adapted by permission from Macmillan Publishers Ltd: Journal of Perinatology. Johnson L, Bhutani VK, Karp K, et al. Clinical report from the Pilot USA Kernicterus Registry (1992 to 2004). J Perinatol 2009; 29:S25. Copyright © 2009. https://www.nature.com/jp/.
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