Page 227 - 16Neonatal Jaundice_compressed

Neonatal jaundice

Bibliographic details Study type and Patient characteristics Methodology and interventions Results Reviewers Comments
Evidence level
mean BW 3192 ± 508 g epidural anaesthesia (P = 0.001)
mean GA 39.3 ± 1.5 weeks mother with blood type O (P < 0.001)
first delivery (P < 0.001)
Gender: Not reported cephalohaematoma (P = 0.003)
Ethnicity: Not reported short gestation (P = 0.01)
lower birthweight (P = 0.01)
Comparison group: lower birth order (P = 0.01)

every tenth admission randomly 2) Factors independently associated with
selected from the group of with
serum bilirubin levels high TSB levels (adj OR with 95% CI)
< 221 micromol/litre
n = 1154 Maternal age > 35 years: Adj OR 1.7
mean BW 3257 ± 444 g (95% CI 1.3–2.3)
Male sex: Adj OR 1.4 (95% CI 1.2–1.7)
mean GA 39.9 ± 1.35 weeks Primipara: Adj OR2.7 (95% CI 2.1–3.5)
Gender: Not reported Previous sibling with jaundice: Adj OR 2.3
Ethnicity: Not reported (95% CI 1.9–2.8)
Early gestation (with 40 weeks as
Exclusion: Not defined reference):
For 37 weeks Adj OR 4.5 (95% CI 3.2–
6.3)
For 38 weeks Adj OR 2.1 (95% CI 1.6–
2.8)
Vacuum extraction: Adj OR 3.0 (95% CI
2.1–4.4)

Khoury MJ et al.; Study type: Offspring of 1669 male US Army 1) Univariate analysis to find Rate of hyperbilirubinaemia in first child Retrospective study
Retrospective veterans who entered the Army association of maternal and of a sibling relationship Selected population with well defined
Year: 1988 study between 1965 and 1971 and who infant variables with exclusion criteria
participated in a nationwide study hyperbilirubinaemia (peak TSB 83/1669 (5.0%) Confounding variables controlled
Country: USA Evidence level: II of veterans’ health (n = 3,301, 580 levels = 205 micromol/litre) Methodology not described adequately
sib-ships with one sibling, 1089 1) Association of factors with
16 sib-ships with two or more 2) Multiple logistic regression hyperbilirubinaemia
siblings) analysis to find factors
independently associated with
Exclusion: hyperbilirubinaemia Preterm birth (GA< 37 weeks) (OR 2.2)
babies who had a different black race (OR 0.37)
breastfeeding (OR 2.1)
mother’s name from the rest of the 3) Recurrence risk of neonatal asphyxia (OR 1.8)
sibling relationship (paternal half hyperbilirubinaemia by sibling
sibs), order and degree of
stillbirths, hyperbilirubinaemia in the first 2) Factors independently associated with
babies with records showing child before and after controlling hyperbilirubinaemia

evidence of haemolytic disease of for confounding variables Year of birth (after 1975 vs before 1975):
newborn. Adj OR1.49 (95% CI 1.03–2.15)
TSB levels for degree of jaundice
Mild: = 205 micromol/litre Preterm birth (GA< 37weeks): Adj OR 2.4
Moderate: 205 to (95% CI 1.4–3.9)

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