Page 218 - 16Neonatal Jaundice_compressed

Neonatal jaundice

Bibliographic details Study type and Patient characteristics Methodology and interventions Results Reviewers Comments
Evidence level
Hispanic = 3.1% hyperbilirubinaemia
Other = 8.2% Decreased risk
Pre-discharge TSB levels
Group 2: infants with post- expressed as risk zone on an Small for gestational age (P = 0.04)
Parity (P = 0.03)
th
discharge TSB < 95 centile on hour-specific bilirubin Caesarean section (P = 0.18)
nomogram nomogram
th
(High risk > 95 centile, High 2) Factors independently associated with
th
th
n = 801 intermediate risk 76 – 95 significant hyperbilirubinaemia from
mean BW 3.3 ± 0.5 kg centile, Low intermediate risk multivariate regression analysis (OR with
mean GA: Not reported 40 – 75 centile, Low risk 0 – 95% CI)
th
th
Gender: males = 52.2% th
Ethnicity: 40 centile) Birthweight: 1.5 (1.2–1.9); P = 0.001
White = 43.1% GA < 38 weeks: 2.6 (1.5–4.5); P = 0.001
Black = 39.9% Significant Hyperbilirubinaemia Oxytocin: 2.0 (1.2–3.4); P = 0.005
th
Asian = 7.7% defined as TSB level > 95 Vacuum delivery: 2.2 (1.5–3.6); P = 0.003
Hispanic = 4.5% centile on hour-specific Exclusive breastfeeding: 2.6 (1.5–4.5); P
Other = 4.7% nomogram. < 0.001
Breast and bottle feeding: 2.3 (1.1–4.9);
P = 0.03

Clinical risk index scoring
Exclusion: admission and
treatment in intensive care nursery Birthweight:
for neonatal illness and babies 3 points for 2501–3000 g
requiring phototherapy during 6 for 3001–3500 g
birth hospitalisation. 9 for 3501–4000 g
12 for 4001–4500 g
15 for 4501–5000 g
GA < 38 weeks: 5 points
Oxytocin: 4 points
Vacuum delivery: 4 points
Exclusive breastfeeding: 5 points
Breast and bottle feeding: 4 points

3) Predictive accuracy for predicting
significant hyperbilirubinaemia

RISK FACTOR SCORE

c-statistic 0.71 (0.66–0.76)

Risk index score 0–7
+LR: 0.1
Risk index score 8–11
+LR: 0.4
Risk index score 12–15
+LR: 0.9

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