Page 254 - 16Neonatal Jaundice_compressed

Neonatal jaundice

Bibliographic details Study type & Patient characteristics Test, Reference Standard, Results Reviewers Comments
Evidence level Threshold for a positive test
39.3 ± 1.4 weeks ETOCc levels but not done in all babies
33 Reference standard: TcB measured At 6–36 hours – No statistical difference Blinding – Not reported
Gender: Males = 51% every 12 hours during the first At 42, 48, 54 and 66 hours – levels
Ethnicity: Not reported 5 days using JM-102, and serum significantly higher in Group 1

Exclusion: TSB measured when TcB
subjects with maternal smoking, index = 22 reflectance units Diagnostic accuracy of ETCOc in predicting
hyperbilirubinaemia

infants of diabetic mother, haemolytic Hyperbilirubinaemia defined as
disease such as blood group TSB = 257 micromol/litre Threshold 1.6 ppm at 36hrs
incompatibilities,
closed space haemorrhage, respiratory Sensitivity: 5/7 (71.4%)
distress, polycythemia. ROC curve used for predicting Specificity: 27/44 (61.4%)
PPV: 5/22 (22.7%)
hyperbilirubinaemia
NPV: 27/29 (93.1%)

Threshold 1.8 ppm at 42hrs
Sensitivity: 6/7 (85.7%)
Specificity: 35/44 (79.5%)
PPV: 6/15 (40%)
NPV: 35/36 (97.2%)

Threshold 1.8 ppm at 48hrs
Sensitivity: 6/7 (85.7%)
Specificity: 32/44 (72.7%)
PPV: 6/18 (33.3%)
NPV: 32/33 (96.9%)

Threshold 1.8 ppm at 60hrs
Sensitivity: 6/7 (85.7%)
Specificity: 29/44 (65.9%)
PPV: 6/21 (28.6%)
NPV: 29/33 (87.9%)

Bhutani VK; Study Type: Birth cohort Test: Prevalence of significant Unselected population
Diagnostic study Term (BW = 2000 g for = 36 weeks) Pre-discharge TSB characterised by hyperbilirubinaemia Test & Reference test described
Year: 1999 and near-term appropriate for postnatal age in hours and adequately
Evidence Level: II gestational age (BW = 2500 g for measured between 18–72 hours Including both pre and post-discharge TSB Reference test a standard test as
Country: GA = 35 weeks) newborn babies in a nomogram developed from lab
USA tertiary hospital (n = 13 003) Reference standard: 230/2840 (8.1%) TSB values
Hour-specific nomogram or TSB Blinding – Not reported
34 For nomogram centiles developed from pre and
n = 2840 post-discharge TSB values. Post-discharge TSB only

mean BW 3318 ± 457 g Post-discharge values obtained on 126/2840 (4.4%)
clinical grounds from day 1–6.
mean GA 38.7 ± 1.3 weeks mean Data recorded in epochs of:
age for pre-discharge sampling 4 hours for first 48 hours, Predictive ability of pre-discharge TSB
percentile tracks as risk demarcators for
33.7 ± 14.6 hours 12 hours for 48–96 hours, subsequent hyperbilirubinaemia (n = 2840)
Gender: Males = 50.1% 24 hours for age 5–7 days.

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