| Predicting significant hyperbilirubinaemia and early discharge for glucose-6-phosphate dehydrogenase deficient newborns. | |
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MedLine Citation:
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PMID: 12772532 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: This study aims to assess the usefulness of day 3 (49 to 72 hours) pre-phototherapy total serum bilirubin (TSB) in predicting subsequent significant hyperbilirubinaemia (SHB) and the feasibility of early discharge for term and near-term glucose-6-phosphate dehydrogenase (G6PD) deficient newborns. MATERIALS AND METHODS: This prospective cohort study involved in born G6PD deficient neonates who were > or = 35 weeks and weighted > or = 2000 g at birth. TSB levels and phototherapy requirements in their first two weeks of life were studied. Day 3 pre-phototherapy TSB in the subgroup weighing > or = 2500 g at birth was analysed for its value in predicting subsequent SHB. RESULTS: Of the 129 neonates, 58 (45%) required phototherapy in the first week. Of these, only 4 patients (3.1%) needed phototherapy to be restarted in the second week. Seventy-one (55%) neonates did not require phototherapy at all. In the absence of SHB in the first week, the probability of its development in the second week was zero (95% confidence interval, 0 to 0.057). In the subgroup weighing > or = 2500 g at birth, day 3 pre-phototherapy TSB < or = 154 umol/L predicted no measurable risk of subsequent SHB (sensitivity, 100%; 95% confidence interval, 91.4% to 100%; negative predictive value, 100%; 95% confidence interval, 86.7% to 100%). CONCLUSIONS: G6PD deficient newborns without SHB in their first week of life were at no measurable risk of its development in the second week. Day 3 pre-phototherapy TSB in the subgroup weighing > or = 2500 g was useful for predicting the risk of subsequent SHB. Low-risk infants, thus identified, may be eligible for discharge on or before day 7 of life. Evidence-based early discharge can decrease the social and financial burden of G6PD deficiency in Singapore. |
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Authors:
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H H Lim; L M Daniel; J Lee; M C Tan |
Publication Detail:
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Type: Evaluation Studies; Journal Article |
Journal Detail:
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Title: Annals of the Academy of Medicine, Singapore Volume: 32 ISSN: 0304-4602 ISO Abbreviation: Ann. Acad. Med. Singap. Publication Date: 2003 Mar |
Date Detail:
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Created Date: 2003-05-29 Completed Date: 2003-10-07 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7503289 Medline TA: Ann Acad Med Singapore Country: Singapore |
Other Details:
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Languages: eng Pagination: 257-61 Citation Subset: IM |
Affiliation:
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Department of Neonatology, KK Women's and Children's Hospital. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Awards and Prizes Bilirubin / blood* Birth Weight Cohort Studies Female Glucosephosphate Dehydrogenase / blood Glucosephosphate Dehydrogenase Deficiency / blood, epidemiology* Humans Incidence Infant, Newborn Jaundice, Neonatal / blood, diagnosis*, therapy Male Neonatal Screening Patient Discharge Phototherapy Predictive Value of Tests Prospective Studies Sensitivity and Specificity Singapore / epidemiology Time Factors |
| Chemical | |
Reg. No./Substance:
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635-65-4/Bilirubin; EC 1.1.1.49/Glucosephosphate Dehydrogenase |
| Comments/Corrections | |
Erratum In:
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Ann Acad Med Singapore. 2003 Jul;32(4):570 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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