Page 250 - 16Neonatal Jaundice_compressed

Neonatal jaundice

Bibliographic details Study type & Patient characteristics Test, Reference Standard, Results Reviewers Comments
Evidence level Threshold for a positive test
TSB = 290 micromol/litre till Day Specificity: 413/438 (94.3%)
5 taken as indicative of PPV: 21/46 (45.6%)
hyperbilirubinaemia NPV: 413/452 (91.4%)

Seidman DS; Study Type: Healthy full term infants with 1) Association of various factors Factors associated with jaundice after Unselected population
Diagnostic study GA = 37 weeks born at two hospitals with jaundice derived from comparing Group 1 vs Group 2 (n = 1177) No differences at baseline
Year: 1999 multiple regression analysis between the two groups
Evidence Level: II n = 1177 Day 1 TSB (per 17 micromol/litre)
Country: mean BW 3247 ± 453 g OR: 3.1 (95% CI 2.4 to 4.1) Test & Reference test described
Israel 2) Comparison of diagnostic in detail
mean GA 39.8 ± 1.3 weeks accuracy of various tests for Change in TSB from day 1 to day 2 (per Reference test a standard one
13 Gender: Males = 47.3% predicting hyperbilirubinaemia 17 micromol/litre) Blinding – Not reported
Ethnicity: Not reported OR: 2.4 (95% CI 1.9 to 3.0) Confounding factors adjusted
Test: for during modelling
TSB measured within first 8 to Maternal age (per year)
Exclusion: 24 hours of life and repeated daily OR: 1.1 (95% CI 1.0 to 1.2) Data not available to calculate
ABO or Rh incompatibility and a for the next 4 days PPV or NPV. Raw figures not
positive direct Coombs’ test Mat education (per year) available
G6PD deficiency. Reference standard: OR: 0.8 (95% CI 0.7 to 0.9)
Hyperbilirubinaemia defined as
TSB Maternal blood type O
> 171 micromol/litre at day 2 OR: 2.9 (95% CI 1.5 to 5.8)
> 239 micromol/litre at day 3
> 291 micromol/litre at day 4–5 Full breastfeeding
OR: 0.4 (95% CI 0.2 to 0.9)
Analysis:
Association between various Day 1 TSB > 85 micromol/litre
factors and jaundice calculated OR: 36.5 (95% CI 15.9 to 83.6)
from multiple regression analysis
using Odds ratios with 95% CI, and Prediction of hyperbilirubinaemia
these factors used for modelling in
predicting hyperbilirubinaemia Prediction by Day 1 TSB only (threshold
value > 85 micromol/litre)
Sensitivity: 63.1%
Specificity: 94.2%

Prediction by all model variables without
Day 1 TSB
Sensitivity: 57.9%
Specificity: 90.4%

Prediction by all model variables
Sensitivity: 81.8%
Specificity: 82.9%

Stevenson DK; Study Type: Newborns with GA = 35 weeks as Test: Prevalence of hyperbilirubinaemia at 30 + Unselected population

198