Document Detail


Transcutaneous bilirubin nomogram for predicting neonatal hyperbilirubinemia in healthy term and late-preterm Chinese infants.
MedLine Citation:
PMID:  20814696     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Zhang-Bin Yu; Xiao-Yue Dong; Shu-Ping Han; Yu-Lin Chen; Yu-Fang Qiu; Li Sha; Qing Sun; Xi-Rong Guo
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-09-03
Journal Detail:
Title:  European journal of pediatrics     Volume:  170     ISSN:  1432-1076     ISO Abbreviation:  Eur. J. Pediatr.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-18     Completed Date:  2011-06-30     Revised Date:  2011-11-28    
Medline Journal Info:
Nlm Unique ID:  7603873     Medline TA:  Eur J Pediatr     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  185-91     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Nanjing Maternal and Child Health Hospital, Nanjing Medical University, Nanjing, China. zhangbinyu@njmu.edu.cn
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MeSH Terms
Descriptor/Qualifier:
Bilirubin / metabolism*
Birth Weight
China / epidemiology
Cohort Studies
Female
Gestational Age
Humans
Hyperbilirubinemia, Neonatal / diagnosis*,  epidemiology,  metabolism
Infant
Infant, Newborn
Infant, Premature / metabolism*
Male
Nomograms*
Predictive Value of Tests
Sensitivity and Specificity
Skin / metabolism*
Time Factors
Chemical
Reg. No./Substance:
635-65-4/Bilirubin
Comments/Corrections
Comment In:
Eur J Pediatr. 2011 Nov;170(11):1485; author reply 1487   [PMID:  21698400 ]

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