Development and validation of serum bilirubin nomogram to predict the absence of risk for severe hyperbilirubinaemia before discharge: a prospective, multicenter study

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• 作者：Costantino Romagnoli (1)
  Eloisa Tiberi (1)
  Giovanni Barone (1)
  Mario De Curtis (2)
  Daniela Regoli (2)
  Piermichele Paolillo (3)
  Simonetta Picone (3)
  Stefano Anania (4)
  Maurizio Finocchi (5)
  Valentina Cardiello (1)
  Lucia Giordano (1)
  Valentina Paolucci (1)
  Enrico Zecca (1)
  
• 关键词：newborn babies ; hyperbilirubinemia ; jaundice ; predictive nomogram
• 刊名：Italian Journal of Pediatrics
• 出版年：2012
• 出版时间：December 2012
• 年：2012
• 卷：38
• 期：1
• 全文大小：583KB
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• 作者单位：Costantino Romagnoli (1)
  Eloisa Tiberi (1)
  Giovanni Barone (1)
  Mario De Curtis (2)
  Daniela Regoli (2)
  Piermichele Paolillo (3)
  Simonetta Picone (3)
  Stefano Anania (4)
  Maurizio Finocchi (5)
  Valentina Cardiello (1)
  Lucia Giordano (1)
  Valentina Paolucci (1)
  Enrico Zecca (1)
  
  1. Department of Pediatrics, Division of Neonatology, Catholic University of the Sacred Heart, Rome, Rome, Italy
  2. Department of Pediatrics, Division of Neonatology, Sapienza University, Rome, Italy
  3. Division of Neonatology, Casilino General Hospital, Rome, Italy
  4. Neonatal Unit, San Filippo Neri, Rome, Italy
  5. Neonatal Unit, Fatebenefratelli San Peter Hospital, Rome, Italy
  

文摘

Background Early discharge of healthy late preterm and full term newborn infants has become common practice because of the current social and economic necessities. Severe jaundice, and even kernicterus, has developed in some term infants discharged early. This study was designed to elaborate a percentile-based hour specific total serum bilirubin (TSB) nomogram and to assess its ability to predict the absence of risk for subsequent non physiologic severe hyperbilirubinaemia before discharge. Methods A percentile-based hour-specific nomogram for TSB values was performed using TSB data of 1708 healthy full term neonates. The nomogram's predictive ability was then prospectively assessed in five different first level neonatal units, using a single TSB value determined before discharge. Results The 75 th percentile of hour specific TSB nomogram allows to predict newborn babies without significant hyperbilirubinemia only after the first 72 hours of life. In the first 48 hours of life the observation of false negative results did not permit a safe discharge from the hospital. Conclusion The hour-specific TSB nomogram is able to predict all neonates without risk of non physiologic hyperbilirubinemia only after 48 to 72 hours of life. The combination of TSB determination and risk factors for hyperbilirubinemia could facilitate a safe discharge from the hospital and a targeted intervention and follow-up.