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Predictors of significant jaundice in late preterm infants

K Radha Lavanya1, Ashish Jaiswal, Pramod Reddy

  • 1Fernandez Hospital, Hyderabad, Andhra Pradesh, India.

Indian Pediatrics
|July 14, 2012
PubMed

Insights

Late preterm infants have a high incidence of significant jaundice. Transcutaneous bilirubin (TcB) measurements at 24-48 hours are more effective predictors of later jaundice than clinical risk factors.

Area of Science:

  • Neonatology
  • Pediatric Gastroenterology
  • Public Health

Background:

  • Late preterm infants (34 0/7 to 36 6/7 weeks gestation) are at increased risk for significant jaundice.
  • Early identification and management of neonatal jaundice are crucial to prevent complications.

Purpose of the Study:

  • To determine the incidence and clinical course of jaundice in late preterm infants.
  • To identify predictors of significant jaundice in this population.

Main Methods:

  • A prospective analytical study was conducted at an urban perinatal center.
  • Late preterm infants were monitored for jaundice until 14 days of life or onset of significant jaundice.
  • Transcutaneous bilirubin (TcB) was measured twice daily for the first 48 hours; clinical risk factors were also recorded.

Main Results:

  • Of 216 infants, 123 (57%) developed significant jaundice, defined by American Academy of Pediatrics (AAP) guidelines.
  • Large for gestational age, lower gestational age, birth trauma, and history of sibling jaundice predicted severe jaundice.
  • TcB measurements at 24-48 hours predicted jaundice onset after 48 hours more effectively than clinical factors.

Conclusions:

  • Significant jaundice is common in late preterm infants.
  • TcB measurements between 24-48 hours of life are superior to clinical risk factors for predicting later significant jaundice.
Abstract

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