Transcutaneous Bilirubin Levels for the First 120 Postnatal Hours in Healthy Neonates

Fouzas, Sotirios; Mantagou, Lito; Skylogianni, Eleni; Mantagos, Stefanos; Varvarigou, Anastasia

doi:10.1542/peds.2009-0403

Cited by 42 publications

(38 citation statements)

References 23 publications

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“…We hence focused on identifying the nomogram with the lowest FNR as screening tool. Our study demonstrates that plotting TcB on transcutaneous nomogram (Maisels and Kring [9] or Fouzas et al [10]) was associated with lower FNR and better predictive characteristics and is likely to be the most useful tool.…”

Section: Discussionmentioning

confidence: 70%

“…- At 48 h of life, the 95th percentile curves in the nomogram of Maisels and Kring (171 μmol/l; 10 mg/dl) [9] and Fouzas et al (188.1 μmol/l; 11 mg/dl) [10] coincides with the 75th percentile curve in the nomogram of Bhutani et al (188.1 μmol/l; 11 mg/dl) [2]. …”

Section: Methodsmentioning

confidence: 89%

“…Although not statistically significant, Fouzas et al [10] obtained the lowest FNR with 8.6/1,000 patients, compared to 10.2/1,000 (Maisels and Kring [9]) and 18.0/1,000 (Bhutani et al [2]). Fouzas also had the best specificity with 87.79% (95% CI: 80.92-92.85).…”

Section: Resultsmentioning

confidence: 99%

“…BiliCheck measurements were plotted on the TSB nomogram of Bhutani et al [2] and on the nomograms of Maisels and Kring [9] and Fouzas et al [10]. …”

Section: Methodsmentioning

confidence: 99%

“…Results from different transcutaneous bilirubinometers are published in the literature and used as predictors of jaundice. Sensitivity, specificity and positive and negative predictive values vary among different studies [6,7,9,10,11,12,13,14,15]. TcB is now routinely measured in clinical practice but evidence-based evaluation of the predictive characteristics of plotting these measurements on the hour-specific TSB is lacking.…”

Section: Introductionmentioning

confidence: 99%

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Plotting Transcutaneous Bilirubin Measurements on Specific Transcutaneous Nomogram Results in Better Prediction of Significant Hyperbilirubinemia in Healthy Term and Near-Term Newborns: A Pilot Study

Mohamed

Blanchard²,

Delvin³

et al. 2014

Neonatology

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Background: The American Academy of Pediatrics has recommended a systematic assessment before discharge for the risk of severe hyperbilirubinemia. Plotting total serum bilirubin (TSB) or transcutaneous bilirubin (TcB) on a TSB hour-specific nomogram is proposed as a tool for laboratory evaluation. Objectives: The aim of this study was to compare the predictive characteristics, particularly the incidence of false negative rate (FNR), of the practice of plotting TcB values on the TSB hour-specific risk nomogram versus on transcutaneous nomogram. Methods: Paired TSB and TcB measurements were conducted on 141 newborns. Risk of developing significant hyperbilirubinemia was defined as infants with bilirubin level ≥75% on TSB or ≥95% on TcB nomogram. TSB values, plotted on the TSB nomogram of Bhutani et al. [Pediatrics 1999;103:6-14], were used as reference. TcB values were plotted on the TSB nomogram and on the transcutaneous nomograms of Maisels and Kring [Pediatrics 2006;117:1169-1173] and Fouzas et al. [Pediatrics 2010;125:e52-e57]. Results: Plotting TcB measurements on a TSB nomogram resulted in a trend towards a higher FNR when compared to Maisels' and Fouzas' nomograms (18.0/1,000 compared to 10.2/1,000 and 8.6/1,000 respectively). Although not statistically significant, plotting TcB on transcutaneous nomogram resulted in better predictive values with the Fouzas' nomogram, having the best sensitivity (90.0%) and specificity (87.79%) as well as the highest positive (35.97%) and negative (99.14%) predictive value. Conclusion: Plotting TcB on a TSB nomogram may result in increased rate of FNR and decreased predictive characteristics. The practice of plotting TcB on a TSB nomogram needs further evaluation.

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Section: Discussionmentioning

confidence: 70%

Section: Methodsmentioning

confidence: 89%

Section: Resultsmentioning

confidence: 99%

“…BiliCheck measurements were plotted on the TSB nomogram of Bhutani et al [2] and on the nomograms of Maisels and Kring [9] and Fouzas et al [10]. …”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Plotting Transcutaneous Bilirubin Measurements on Specific Transcutaneous Nomogram Results in Better Prediction of Significant Hyperbilirubinemia in Healthy Term and Near-Term Newborns: A Pilot Study

Mohamed

Blanchard²,

Delvin³

et al. 2014

Neonatology

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Newborn Visit

Kramer¹

2017

Primary Well-Being: Case Studies for the Growing Child

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Transcutaneous bilirubin nomogram for predicting neonatal hyperbilirubinemia in healthy term and late-preterm Chinese infants

Dong

Han

et al. 2010

Eur J Pediatr

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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.

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Transcutaneous Bilirubin Levels for the First 120 Postnatal Hours in Healthy Neonates

Abstract: We provide data on TcB levels for the first 120 postnatal hours from a large population of white, healthy, term and near-term neonates. We also present a percentile-based TcB nomogram designated for noninvasive and hour-specific evaluation of neonatal hyperbilirubinemia.

Cited by 42 publications

References 23 publications

Plotting Transcutaneous Bilirubin Measurements on Specific Transcutaneous Nomogram Results in Better Prediction of Significant Hyperbilirubinemia in Healthy Term and Near-Term Newborns: A Pilot Study

Plotting Transcutaneous Bilirubin Measurements on Specific Transcutaneous Nomogram Results in Better Prediction of Significant Hyperbilirubinemia in Healthy Term and Near-Term Newborns: A Pilot Study

Newborn Visit

Transcutaneous bilirubin nomogram for predicting neonatal hyperbilirubinemia in healthy term and late-preterm Chinese infants

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