Prospective Validation of a Novel Strategy for Assessing Risk of Significant Hyperbilirubinemia

• Type: Article in International Scientific Journal
• Date: 2011

Authors

Goncalves, A (Author) Other; Costa, S (Author) Other; Lopes, A (Author) Other; Rocha, G (Author) Other; Guedes, MB (Author) Other; Centeno, MJ (Author) Other; Silva, J (Author) Other; Silva, MG (Author) Other; Severo M (Author) FMUP; Guimarães H (Author) FMUP

Journal

Title: Pediatrics

Vol. 127

Pages: E126-E131

ISSN: 0031-4005

Publisher: American Academy of Pediatrics

Indexing

ISI Web of Knowledge - 7 Citations

Scopus - 6 Citations

Pubmed / Medline

Scientific classification

FOS: Medical and Health sciences > Other medical sciences

CORDIS: Health sciences > Medical sciences > Medicine > Pediatrics

Other information

Authenticus ID: P-002-ZA9

DOI: 10.1542/peds.2009-2771

Abstract (EN): OBJECTIVE: Our aim was to validate a strategy for assessing the risk of significant hyperbilirubinemia in newborns with gestational ages of >= 35 weeks by combining predischarge bilirubin percentile data with gestational age data, for a European, predominantly white population. METHODS: We conducted a prospective cohort study with 463 newborns with gestational ages of >= 35 weeks who were admitted to the well-infant nursery. Total bilirubin levels were measured daily until discharge and once after discharge, between the third and eighth days of life, by using a Bilicheck device (Respironics, Murrysville, PA). The values obtained (<52 hours) were plotted on an hour-specific bilirubin nomogram to determine the infant's bilirubin percentile, expressed as a risk zone. Patients were assigned to 1 of 3 risk groups (very low, low, or high) on the basis of a combination of risk zone and gestational age data and were monitored prospectively for the development of significant hyperbilirubinemia. The 95% confidence interval (CI) for the prevalence of significant hyperbilirubinemia was estimated with the binomial distribution method. RESULTS: Forty-four infants (11%) developed significant neonatal hyperbilirubinemia. The risks of developing significant hyperbilirubinemia were 1.3% (95% CI: 0.2%-3.7%) for the very low risk group (n = 230 [58.1%]), 3.4% (95% CI: 0.7%-9.8%) for the low risk group (n = 86 [21.7%]), and 47.50% (95% CI: 36.2%-59.0%) for the high risk group (n = 80 [20.20%]). CONCLUSIONS: The proposed strategy, based on predischarge bilirubin level and gestational age data, was a valid method for significant hyperbilirubinemia risk assessment in our population. Pediatrics 2011;127:e126-e131

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 6