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Predicting Neonatal Hyperbilirubinemia Using First Day Serum Bilirubin Level in Late Preterm and Term Healthy Newborn
1Dr Md Kamrul Ahsan Khan, Assistant Professor (Neonatology), Department of Pediatrics, Sheikh Sayera Khatun Medical College, Gopalgonj, Bangladesh.
Mymensingh Medical Journal : MMJ
|December 7, 2017
Summary
A day 1 total serum bilirubin (TSB) level of 5.65mg/dl can predict significant hyperbilirubinemia in newborns. This screening test helps identify infants needing closer follow-up to prevent complications.
Area of Science:
- Neonatology
- Pediatric Medicine
- Public Health
Background:
- Neonatal hyperbilirubinemia is a frequent cause of hospital readmission for healthy term and late preterm infants.
- Early discharge policies and limited follow-up in developing nations necessitate predictive tools for managing neonatal jaundice.
- Effective prediction of hyperbilirubinemia is crucial for timely intervention and prevention of complications.
Purpose of the Study:
- To evaluate the predictive value of day 1 total serum bilirubin (TSB) levels for significant hyperbilirubinemia in newborns.
- To determine the optimal cutoff value of day 1 TSB for identifying neonates at risk.
- To aid in the early management and prevention of complications associated with neonatal jaundice.
Main Methods:
- An observational analytical study involving 100 healthy late preterm and term neonates.
- Measurement of day 1 total serum bilirubin (TSB) levels.
- Receiver Operating Characteristic (ROC) analysis to identify the best predictive cutoff value for significant hyperbilirubinemia (defined as TSB ≥17mg/dl after 72 hours).
Main Results:
- A total of 89 neonates were analyzed, with 15.74% developing significant hyperbilirubinemia.
- Mean day 1 TSB was significantly higher in neonates who developed hyperbilirubinemia (5.97±1.74mg/dl) compared to those who did not (3.19±1.4mg/dl).
- A day 1 TSB level of ≥5.65mg/dl demonstrated high sensitivity (86%) and specificity (91%) for predicting significant hyperbilirubinemia (AUC-0.880, p=0.001), with a negative predictive value of 97%.
Conclusions:
- Day 1 total serum bilirubin level is a reliable predictor of subsequent significant hyperbilirubinemia in late preterm and term neonates.
- A day 1 TSB cutoff of 5.65mg/dl is recommended for identifying infants requiring close follow-up.
- Strict monitoring of infants with a day 1 TSB ≥5.65mg/dl is essential for early detection and management of neonatal jaundice.
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