Page 212 - 16Neonatal Jaundice_compressed
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Appendix H: Evidence tables


              Bibliographic details   Study type and   Patient characteristics   Methodology and interventions   Results    Reviewers Comments
                               Evidence level
                                                                                              Bruising: OR 4.0 (1.8–8.8)
                                                                                              Cephalohaematoma: OR 3.3 (1.1–10)
                                                                                              Maternal age ≥ 25 years: OR 3.1 (1.2–8.1)
                                                                                              Family history of jaundice: 6.0 (1.0–36.0);
                                                                                              P = 0.05

                                                                                              Risk Index scoring

                                                                                              6 points each for exclusive breastfeeding
                                                                                              and family HISTORY OF jaundice in a
                                                                                              newborn,
                                                                                              4 points each for bruising and Asian race,
                                                                                              3 points each for cephalhematoma and
                                                                                              maternal age ≥ 25 years,
                                                                                              1 point for male sex, -2 points for black
                                                                                              race, and 2(40-GA)

                                                                                              Accuracy of Risk Index score in predicting
                                                                                              significant hyperbilirubinaemia

                                                                                              Overall c-statistic 0.85

                                                                                              Risk index score < 10
                                                                                              +LR: 0.2

                                                                                              Risk index score > 10
                                                                                              +LR: 2.2

                                                                                              Risk index score > 20
                                                                                              +LR: 18.2

              Newman TB et al.;   Study Type:   Cohort of all infants with   1) Frequency of jaundice noted   1) Frequency of jaundice noted in   Nested case–control study
                               Nested case-   BW = 2000 g and GA = 36 weeks   in the medical record in term and   newborns within 24 hours of age (Kaplan
              Year: 2002       control study   born alive at 12 hospitals of a   near-term newborns less than   Meier survival estimates + no. with TSB   Some cases were included in 42290 –
                                             health maintenance organisation   24 hours old   measured)                     should we excluded 42290
              Country: USA     Evidence Level: II   during a four year period
                                             (n = 105 384)                                                                  Cases and controls taken from comparable
              10                                                      2) Association of jaundice noted   Less than 18 hours of age   populations but exclusion criteria not well
                                             Cases: Babies with maximum TSB   in the first 24 hours after birth   3.8%      defined
                                             levels = 428 micromol/litre within   with the use of phototherapy and          Confounding variables controlled
                                             the first 30 days after birth   risk of developing   Less than 24 hours of age   Methodology described adequately but
                                                                                              6.7%
                                                                      hyperbilirubinaemia after
                                             (n = 140)                controlling for confounding                           exact number of babies with jaundice
                                                                      variables -             2) Association of jaundice noted within   noted in first 24 hours calculated with
                                             Controls: Random sample of                                                     Kaplan Meier analysis
                                             babies from the cohort with                      24 hours of age with risk factors (results of
                                             maximum TSB                                      bivariate analysis)
                                             levels = 428 micromol/litre
                                             (n = 631)                                        No statistically significant difference


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