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Appendix H: Evidence tables
Bibliographic details Study type and Patient characteristics Methodology and interventions Results Reviewers Comments
Evidence level
OR 8.3 (95% CI 1.2–111.8); P = 0.03
Maximum TSB levels:
OR 1.15 (195% CI .04–1.3); P = 0.005
Free bilirubin levels:
OR 1.1 (95% CI 1.04–2.2); P = 0.009
Turkel BS et al.; Study type: All infants with kernicterus found Multiple historical, clinical, and There were no statistically significant It was difficult to separate infants with and
Retrospective at autopsy. laboratory factors were differences between the kernicteric and without kernicterus at autopsy on the basis
Year: 1980 matched-control 32 infants identified with compared, including non-kernicteric infants for any of the of the clinical factors evaluated.
study kernicterus matched to 32 control therapy factors, including peak total serum
Country: USA Evidence level: II infants without kernicterus at sepsis bilirubin levels. Some cases of kernicterus may have been
autopsy born during the same year, hypothermia missed due to the variables of relying on
21 of like gestational age, weight and asphyxia (Apgar score) The multivariate analysis failed to identification in fixed or fresh brains.
length of survival. haematocrit determine a group of factors associated
acidosis with increased risk for kernicterus.
A second group of 13 pairs from hypercarbia
the large group of 32 pairs were hypoxia
matched for sex as well. hypoglycaemia
hyperbilirubinaemia
Bhutani VK et al.; Study Type: 125 of 142 cases of the Pilot Main outcome measures were the The total serum bilirubin levels, age at re- Late preterm birth (34 0/7 to 36 6/7 week s)
Retrospective Kernicterus Registry met the comparison of hospitalisation, and birthweight of healthy babies was not recognised as a
Year:2006 study inclusion criteria. etiology, severity and duration of distribution were similar for late preterm risk factor for hazardous
These babies were discharged as extreme hyperbilirubinaemia and term infants. hyperbilirubinaemia by clinical
Country: USA Evidence Level: healthy and were included for (total serum bilirubin levels practitioners.
III analysis if they exhibited clinical > 343 micromol/litre), Large for gestational age and late preterm
20 signs of acute bilirubin response to interventions of infants disproportionately developed
encephalopathy regardless of total intensive phototherapy and kernicterus as compared with those who
serum bilirubin levels. exchange transfusion, were appropriate for gestational age and
healthcare delivery experiences term.
in preterm as compared with
term infants. Clinical management of extreme of
hyperbilirubinaemia, by the attending
clinical providers, was not impacted or
influenced by the gestational age, clinical
signs, or risk assessment. This resulted in
severe posticteric sequelae which was
more severe and frequent in late preterm
infants.
Newman T Study Type: The study population included first Babies had TSB measured About 1% of the white babies (n = 21 375) Selected population
prospective cohort born white and black babies with between 36 and 60 hours of age had peak TSB level = 342 micromol/litre Comparison of baseline characteristics
Year: 1993 study birthweight = 2500 g who survived (as close to 48 hours as possible) while the proportion among the black done
for at least 1 year and had at least and subsequent sampling was babies (n = 19 949) was 0.6%. Confounding variables controlled
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