A Model for Predicting Significant Hyperbilirubinemia in Neonates From China

Han, Song; Yu, Zhangbin; Liu, Ling; Wang, Jimei; Wei, Qiufen; Jiang, Chunming; Guo, Jinzhen; Li, Mingxia; Yang, Jie; Shah, Prakesh S.; Chen, Chao

doi:10.1542/peds.2014-4058

Cited by 28 publications

(22 citation statements)

References 29 publications

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“…A key limitation of the study is the lack of information about TSB levels that would have allowed us to assess the severity of hyperbilirubinemia. The lack of these data is likely a primary reason that the models in this study had lower predictive value compared with existing models that include TSB levels . We were, however, able to pinpoint biomarkers other than bilirubin that are associated with hyperbilirubinemia and to predict hyperbilirubinemia across a greater range of GAs and ethnicities than any existing models.…”

Section: Discussionmentioning

confidence: 70%

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Newborn Metabolic Profile Associated with Hyperbilirubinemia With and Without Kernicterus

McCarthy

Oltman

Baer

et al. 2018

Clinical Translational Sci

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Our objective was to assess the relationship between hyperbilirubinemia with and without kernicterus and metabolic profile at newborn screening. Included were 1,693,658 infants divided into a training or testing subset in a ratio of 3:1. Forty‐two metabolites were analyzed using logistic regression (odds ratios (ORs), area under the receiver operating characteristic curve (AUC), 95% confidence intervals (CIs)). Several metabolite patterns remained consistent across gestational age groups for hyperbilirubinemia without kernicterus. Thyroid stimulating hormone (TSH) and C‐18:2 were decreased, whereas tyrosine and C‐3 were increased in infants across groupings. Increased C‐3 was also observed for kernicterus (OR: 3.17; 95% CI: 1.18–8.53). Thirty‐one metabolites were associated with hyperbilirubinemia without kernicterus in the training set. Phenylalanine (OR: 1.91; 95% CI: 1.85–1.97), ornithine (OR: 0.76; 95% 0.74–0.77), and isoleucine + leucine (OR: 0.63; 95% CI: 0.61–0.65) were the most strongly associated. This study showed that newborn metabolic function is associated with hyperbilirubinemia with and without kernicterus.

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Section: Discussionmentioning

confidence: 70%

“…A number of investigators have explored creation of screening tools that utilize characteristics to identify high‐risk infants. Existing predictive models are based upon characteristics, such as TSB levels, mode of delivery, gestational age (GA), and body mass loss …”

mentioning

confidence: 99%

Newborn Metabolic Profile Associated with Hyperbilirubinemia With and Without Kernicterus

McCarthy

Oltman

Baer

et al. 2018

Clinical Translational Sci

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“…The combination of bilirubin level and clinical factors, especially gestational age, increases the predictive accuracy of the model as shown in previous studies. 14,15,17,23 As the result, we constructed the clinical predictive score for predicting subsequent hyperbilirubinemia by combining TcB levels at 48e54 h of life with gestational age which had good predictive ability of AuROC 0.81 (95% CI: 0.76, 0.86).…”

Section: Discussionmentioning

confidence: 99%

Clinical predictive score of predischarge screening for severe hyperbilirubinemia in late preterm and term infants

2020

Pediatrics & Neonatology

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Available online ---Key Words clinical predictive score; hyperbilirubinemia; neonatal Background: Early identification and appropriate follow-up of infants at risk of severe hyperbilirubinemia are part of preventing complications. This study aims to develop the clinical predictive score to predict subsequent severe hyperbilirubinemia in healthy Thai infants. Methods: A case-control study was conducted using medical records of 147 hyperbilirubinemia cases and 147 age-matched controls among healthy late preterm and term Thai newborn infants during January 2015 and December 2016. The routinely measured TcB values at 48e54 hours of age and all predischarge clinical characteristics were collected. Multivariable logistic regression was used to find a clinical prediction model to predict subsequent severe hyperbilirubinemia within 7 days after birth which defined as a postdischarge bilirubin level exceeding the hour-specific recommended threshold for phototherapy by the American Academy of Pediatrics (AAP). Results: The best clinical predictors for subsequent severe hyperbilirubinemia were TcB values at 48e54 hours and gestational age of infants. Predischarge TcB at 48e54 hours of life was classified into 3 levels: < 10 mg/dL, 10e12 mg/dL and > 12 mg/dL. Gestational age was categorized into 5 groups. The risk score derived from these 2 significant factors predicted subsequent severe hyperbilirubinemia with an AuROC curve of 81.0% (95% CI: 76.2e85.9%) in 3 risk group, high, moderate and low. The positive likelihood ratio for subsequent severe hyperbilirubinemia of the high-risk group (score > 5) was 4.53 (95% CI: 2.91e7.04) with specificity of 87.1%. The negative predictive value of low-risk group (score < 3) was 81%. Conclusions: A simple predischarge prediction score using gestational age and TcB values at 48 e54 hours of life was developed. This score classified late preterm and term newborn infants into 3 distinct risk levels and may be useful to identify high-risk infants for outpatient followup of subsequent severe hyperbilirubinemia.

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“…Hyperbilirubinemia is a common condition occurring in neonatal periods 1 , with a prevalence of around 60% in term neonates and 80% in preterm neonates. Preterm neonates have a greater risk of severe hyperbilirubinemia, which can lead to encephalopathy 2 .…”

Section: Introductionmentioning

confidence: 99%

Transcutaneous bilirubin level to predict hyperbilirubinemia in preterm neonates

et al. 2020

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Background: Hyperbilirubinemia is common in neonates, with higher prevalence among preterm neonates, which can lead to severe hyperbilirubinemia. Assessment of total serum bilirubin (TSB) and the use of a transcutaneous bilirubinometry (TcB) are existing methods that identify and predict hyperbilirubinemia. This study aimed to determine TcB cut-off values during the first day for preterm neonates to predict hyperbilirubinemia at 48 and 72 hours. Methods: This cohort study was conducted at Dr. Soetomo General Hospital from September 2018 to January 2019 a total of 90 neonates born ≤35 weeks. They were divided into two groups (Group I: 1000-1500 grams; Group II: 1501-2000 grams). The bilirubin levels were measured on the sternum using TcB at the ages of 12, 24, and 72 hours. TSB measurements were taken on the third day or if the TcB level reached phototherapy threshold ± 1.24 mg/dL and if TcB showed abnormal results (Group I: 5.76-8.24 mg/dL; Group II: 8.76-11.24 mg/dL). Hyperbilirubinemia was defined as TSB ≥7 mg/dL for Group I and >10 mg/dL for Group II. Results: In total, 38 Group I neonates and 48 Group II neonates were observed. Almost half of the neonates in Group I (45%) suffered from hyperbilirubinemia at the age of 48 hours, along with 46% of Group II at 72 hours. The best 24-hour-old TcB cut-off values to predict hyperbilirubinemia at 48 hours were calculated to be 4.5 mg/dL for Group I and 5.8 mg/dL for Group II. The determined 24-hour-old TcB value to predict hyperbilirubinemia at 72 hours was 5.15 mg/dL for Group II. Conclusion: TcB values in the early days of life can be used as hyperbilirubinemia predictors on the following days for preterm neonates. Close monitoring should be managed for those with TcB values higher than the calculated cut-off values.

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A Model for Predicting Significant Hyperbilirubinemia in Neonates From China

Cited by 28 publications

References 29 publications

Newborn Metabolic Profile Associated with Hyperbilirubinemia With and Without Kernicterus

Newborn Metabolic Profile Associated with Hyperbilirubinemia With and Without Kernicterus

Clinical predictive score of predischarge screening for severe hyperbilirubinemia in late preterm and term infants

Transcutaneous bilirubin level to predict hyperbilirubinemia in preterm neonates

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