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  • Title: [Predictive value of hour-specific transcutaneous bilirubin nomogram for neonatal hyperbilirubinemia: a national multicenter study].
    Author: Chinese Multicenter Study Coordination Group for Neonatal Hyperbilirubinemia.
    Journal: Zhonghua Er Ke Za Zhi; 2015 Nov; 53(11):830-4. PubMed ID: 26758321.
    Abstract:
    OBJECTIVE: To assess the predictive value of hour-specific transcutaneous bilirubin (TcB) nomogram for subsequent neonatal hyperbilirubinemia. METHOD: Thirteen tertiary class-A hospitals (including two hospitals respectively in the northeastern, northern, eastern, south, northwest, southwestern regions of China, and one in central region) participated in this multicenter study between January 1 and December 31, 2013. All TcB measurements were obtained from healthy term and near-term newborns (gestational age ≥ 35 weeks, birth weight ≥ 2 000 g) by the JM-103 bilirubinometer between 0 and 168 postnatal hours.Developed an hour-specific TcB bilirubin nomogram with these data.Newborns were divided into 4 groups based on the predischarge bilirubin "risk zone" (≤ P40, >P40-P75, >P75-P95, and > P95 as low, low-intermediate, high-intermediate and high risk zones on the hour-specific bilirubin nomogram) to predict subsequent hyperbilirubinemia.Selected bilirubin measurements of three time quantums (25-48 h, 49-72 h, 73-96 h) as a predictor for the respective danger zone, and adopted ROC curve to assess the predictive ability of the TcB nomogram. RESULT: Data from 19 601 healthy term and near-term newborns, and 2 673 cases with neonatal hyperbilirubinemia were collected. The prevalence was 13.6%. The P40, P75, and P95 peak percentile value of the hour-specific TcB nomogram was 167, 206, 253 µmol/L, respectively. The rate of rise in TcB was highest during the first 24 h of age, and the 95(th) percentile curve was faster than the P40 and P75 percentile curves. The areas under the ROC curves of 25-48 h, 49-72 h and 73-96 h were respectively 0.752 0, 0.834 4, 0.856 1. During 25-48 h, 49-72 h and 73-96 h after birth, the TcB before discharge were in the high-risk zone, its prevalence was 49.4%, 67.3%, 80.4%, its likelihood ratio was 6.20, 13.0, and 27.8, respectively. CONCLUSION: The constructed TcB nomogram shows a good predictivity for hyperbilirubinemia.
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