Estimation de la bilirubinémie par méthode transcutanée chez le nouveau-né prématuré

Mercanti, I; Michel, Fabrice; Thomachot, Laurent; Loundou, D.-A.; Nicaise, C.; Vialet, Renaud; Marco, Jean; Lagier, P.; Martin, Claude

doi:10.1016/j.arcped.2007.02.091

Cited by 8 publications

(1 citation statement)

References 20 publications

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“…However, studies carried out in preterm neonates have yielded varying results. TcB-TSB correlation seems to decrease when gestational age (GA) is low [6,7,8,9]. There are few studies of very preterm babies <30 weeks' GA, and results have often proven contradictory [10].…”

Section: Introductionmentioning

confidence: 99%

Diagnosis Accuracy of Transcutaneous Bilirubinometry in Very Preterm Newborns

Rubio¹,

Epiard

Gebus

et al. 2016

Neonatology

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Background: Transcutaneous bilirubin (TcB) is a validated test for systematic screening of neonatal hyperbilirubinemia and monitoring term and near-term infants under phototherapy. Objectives: To evaluate TcB diagnostic accuracy for very preterm neonates. Methods: Total serum bilirubin (TSB) and TcB measurements were performed prospectively in a multicenter sample of newborns <30 weeks of gestational age (GA). TcB sensitivity, specificity, predictive values, and likelihood ratios for the detection of neonates requiring phototherapy were calculated over the first 15 days of life, with or without phototherapy, with the expectation of achieving a detection rate of hyperbilirubinemia of over 95%. The potential influence of neonatal characteristics on the discordance between TcB and TSB in very preterm newborns was analyzed using multivariate multilevel logistic regression analyses. Results: Altogether, 481 measurements were analyzed in 167 preterm patients. Mean GA was 27.6 ± 1.6 weeks. The rates of newborns requiring phototherapy were 52% in the first 3 days, 16% from the 4th to the 7th day, and 2% during the second week. Diagnostic performance was similar among babies with or without phototherapy. TcB sensitivity decreased over time from 100% (93.9-100.0) to 50% (1.3-98.7). Specificity showed an inverse evolution from 14.8% (7.0-26.2) to 80.7% (72.2-89.2). The best performance was that of negative predictive values which varied from 95.5 to 100.0. False negatives were rare throughout the study (0.8% of measurements). In a multivariate analysis, the only factor significantly influencing discordance between TcB and TSB was postnatal age. We did not find any impact of GA and skin color. Conclusion: Among very preterm babies, TcB measurements might be useful for screening for neonatal jaundice in the first 2 weeks of life. In case of a TcB value below the phototherapy threshold, invasive TSB quantification could be unnecessary, with potential avoidance of blood drawing.

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