Value of hour-specific transcutaneous bilirubin nomogram for prediction of hyperbilirubinemia in healthy neonates

SHI Bi-Zhen, CHEN Lan, HAN Shu-Ping, CHEN Chao, LIU Ling

Chinese Journal of Contemporary Pediatrics ›› 2016, Vol. 18 ›› Issue (3) : 201-205.

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Chinese Journal of Contemporary Pediatrics ›› 2016, Vol. 18 ›› Issue (3) : 201-205. DOI: 10.7499/j.issn.1008-8830.2016.03.002
CLINICAL RESEARCH

Value of hour-specific transcutaneous bilirubin nomogram for prediction of hyperbilirubinemia in healthy neonates

  • SHI Bi-Zhen1, CHEN Lan1, HAN Shu-Ping2, CHEN Chao3, LIU Ling1
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Abstract

Objective To plot a hour-specific transcutaneous bilirubin (TCB) nomogram for healthy neonates, and to evaluate its value for prediction of the risk of neonatal hyperbilirubinemia. Methods A total of 5 250 healthy fullterm or near-term neonates (gestational age ≥35 weeks, birth weight ≥2 000 g) were enrolled as subjects. Their TCB values were continuously recorded for 168 hours after birth. The TCB values in the high-risk zones of three time periods, 24-48, 49-72, and 73-96 hours after birth, were used as predictors. The hour-specific TCB nomogram combined with the receiver operating characteristic (ROC) curve was used to evaluate the predictive value of hour-specific TCB nomogram for hyperbilirubinemia. Results According to the hour-specific TCB nomogram, the TCB value dramatically increased during 16-72 hours after birth, and the increase slowed down gradually during 72-144 hours. Finally, the curve reached a plateau after 144 hours. Particularly, the P95 of TCB had been stabilized at 96 hours. The P40, P75, and P95 peak values of TCB were 173, 217, and 248 μmol/L, respectively. For the prediction of hyperbilirubinemia, the areas under the ROC curve of TCB at 24-48, 49-72, and 73-96 hours after birth were 0.77, 0.85, and 0.87, respectively. The high-risk zones at 24-48, 49-72, and 73-96 hours after birth predicted the incidence rates of neonatal hyperbilirubinemia as 35.03%, 43.35%, and 79.95%, respectively, with positive likelihood ratios of 3.35, 4.75, and 22.70, respectively. Conclusions The hour-specific TCB nomogram and the division of TCB risk zones can give a satisfactory prediction of the incidence of neonatal hyperbilirubinemia. The neonate with a bilirubin level in the high-risk zone within 73-96 hours after birth is likely to have hyperbilirubinemia after 73-96 hours.

Key words

Hour-specific transcutaneous bilirubin nomogram / Hyperbilirubinemia / Neonate

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SHI Bi-Zhen, CHEN Lan, HAN Shu-Ping, CHEN Chao, LIU Ling. Value of hour-specific transcutaneous bilirubin nomogram for prediction of hyperbilirubinemia in healthy neonates[J]. Chinese Journal of Contemporary Pediatrics. 2016, 18(3): 201-205 https://doi.org/10.7499/j.issn.1008-8830.2016.03.002

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