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- Title
Transcutaneous bilirubin nomogram for predicting neonatal hyperbilirubinemia in healthy term and late-preterm Chinese infants.
- Authors
Zhang-Bin Yu; Xiao-Yue Dong; Shu-Ping Han; Yu-Lin Chen; Yu-Fang Qiu; Li Sha; Qing Sun; Xi-Rong Guo; Yu, Zhang-Bin; Dong, Xiao-Yue; Han, Shu-Ping; Chen, Yu-Lin; Qiu, Yu-Fang; Sha, Li; Sun, Qing; Guo, Xi-Rong
- Abstract
Identifying infants that will develop significant hyperbilirubinemia with the risk of kernicterus, and planning appropriate follow-up strategies, is particularly challenging. In this study, 36,921 transcutaneous bilirubin (TcB) measurements were obtained from 6,035 healthy neonates (gestational age ≥ 35 weeks and birth weight ≥ 2,000 g) between January 1 and December 31, 2009. All measurements were performed with the JM-103 bilirubinometer at designated times between 0 and 168 postnatal hours. TcB percentiles were calculated and used to develop an hour-specific nomogram. The rate of increase in TcB was higher during the first 72 h of age, after which levels declined to a plateau by 72-108 h of age. We constructed a TcB nomogram by using the 40th, 75th, and 95th percentile values of TcB for every 12 h of the studied interval. The 75th percentile curve of the nomogram may be an ideal cutoff point for intensive follow-up of the neonate for hyperbilirubinemia as it carries very high sensitivity (78.7%) and negative predictive value (98.5%). The specificity (45.7%) and positive predictive value (15.5%) decreased to reach their lowest levels at the 40th percentile. Of the neonates in the high-risk zone, 167 (48.8%) infants had persistent subsequent hyperbilirubinemia post-discharge, compared with 292 (27.0%) infants in the high-intermediate-risk zone at discharge. One-hundred and seventeen (5.5%) infants in the low-intermediate-risk zone moved into the high-risk zone during follow-up. No newborn infants in the low-risk zone became high-risk during follow-up. We provide an hour-specific TcB nomogram to predict neonatal hyperbilirubinemia in healthy term and late-preterm Chinese infants.
- Subjects
BILIRUBIN; NEONATAL jaundice; HYPERBILIRUBINEMIA; CHINESE people; INFANT diseases; DISEASES
- Publication
European Journal of Pediatrics, 2011, Vol 170, Issue 2, p185
- ISSN
0340-6199
- Publication type
journal article
- DOI
10.1007/s00431-010-1281-9