Prediction of Neonatal Hyperbilirubinemia Using 1st Day Serum Bilirubin Levels
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The study was conducted on Full term neonates with birth weight > 2.5 kg born in KIMS, Hubballi with an objective to determine the first day Total Serum Bilirubin (TSB) value so as to predict subsequent development of significant hyperbilirubinemia in term neonates. All enrolled neonates were sampled for TSB and blood group on Day 1 at 20 ± 4 h and then followed up clinically by Kramer’s rule and when the clinical jaundice by Kramer’s rule was >10 mg/dl, TSB levels were repeated. A total of 180 newborns were enrolled for the study and 165 babies completed the study. Out of these, 17(10.3%) babies had significant hyperbilirubinemia by day 5 of life. Using Receiver Operating Characteristic (ROC) Curve, a cut off TSB value of 6.15 mg/dl was determined with sensitivity of 82.4%, specificity of 81.8%, positive predictive value of 32.8%, negative predictive value 97.6%. In term neonates, the first day total bilirubin level at 20 ± 4 h of life <6.15 predicts the low risk of subsequent significant hyperbilirubinemia with high probability.
KeywordsHyperbilirubinemia Term neonates Bilirubin Prediction
SMS: Collected and analysed the data and wrote the manuscript; SFD: Constructed the plan of study, helped in writing the manuscript and supervised the work; VHR: Helped in data analysis, writing the manuscript and supervised the work; PKW: Helped and guided in writing the manuscript and supervised the work. VHR will act as guarantor for this paper.
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- 1.Cloherty JP, Gregory MLP, Martin CR. Neonatal hyperbilirubinemia. In: Cloherty JP, Gregory MLP, Martin CR, editors. Manual of neonatal care. 7th ed. Philadelphia: Wolters Kluwer; 2012. p. 304–39.Google Scholar
- 2.Taeusch HW, Ballard RA, Gleason CA. Neonatal hyperbilirubinemia. In: Madan A, James R, MacMahon, Stevenson DK, editors. Avery’s diseases of the newborn. 8th ed. Philadelphia: Saunders, Mosby; 2005. p. 1226–56.Google Scholar
- 3.Barrett KE, Boitano S, Barman SM. Transport & metaboloic functions of the liver. In: Barrett KE, Boitano S, Barman SM, editors. Ganong's review of medical physiology. 24th ed. New York: Mcgraw-Hill Education; 2012. p. 512–3.Google Scholar
- 4.Maisels MJ, Bhutani VK, Newman TB, et al; American Academy of Pediatrics. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2004;144:297–316.Google Scholar
- 9.Agarwal R, Kaushal M, Paul VK, Agarwal R, Deorari AK. Early neonatal hyperbilirubinemia using first day serum bilirubin level. Indian Pediatr. 2002;39:724–30.Google Scholar