Page 258 - 16Neonatal Jaundice_compressed

Neonatal jaundice

Bibliographic details Study type & Patient characteristics Test, Reference Standard, Results Reviewers Comments
Evidence level Threshold for a positive test
mean GA 40 ± 1.8 weeks Hour-specific nomogram. TSB 15 as risk demarcators for subsequent
Gender: Males = 51.6% curves developed from TSB values hyperbilirubinaemia
measured at 6 hours of age and
Ethnicity: Not reported then every 4–6 hours during day
HOSPITAL A
Exclusion: and 6–12 hours during night.
congenital anomalies, Curves of babies with TSB Prevalence of TSB > 205 micromol/litre
> 205 micromol/litre and those
any illness requiring admission to with TSB > 205 micromol/litre 230/1244 (18.5%)
neonatal intensive care unit, st
infants with delayed meconium taken separately, their 1 Prevalence of TSB > 205 micromol/litre
passage, percentile TSB values determined
hypothermia, for each hour of life and connected 100/1244 (8.0%)

hypoglycaemia, cephalohematoma, to form percentile tracks. Single TSB measurement with Trend 12 as
local bleeding, threshold
hemorrhagic disease of newborn, Predictive ability of TSB levels
UTI or suspected clinical sepsis. measured in Phase 2 evaluated for Sensitivity: 228/230 (99.1%)
subsequent hyperbilirubinaemia at Specificity: 496/1014 (48.9%)
24–36 hours, 37–48 hours, 49– PPV: 228/746 (30.6%)
NPV: 496/498 (99.6%)
60 hours, 61–72 hours and all + LR: 1.9
Phase 2: Application of the together
nomogram (threshold value –
Healthy term babies in two hospitals Trend 12 defined as TSB value Single TSB measurement with Trend 15 as
threshold
st
who had TSB estimation between 30– exceeding the 1 percentile track Sensitivity: 100/100 (100%)
72 hours due to clinical jaundice of babies with TSB Specificity: 859/1144 (75.1%)
> 205 micromol/litre, and Trend 15 PPV: 100/385 (26.0%)
defined as TSB value exceeding the
Hospital A: st NPV: 859/859 (100%)
+LR: 4.0
n = 1244, 1 percentile track of babies with
mean BW 3299 ± 447 g, TSB > 256 micromol/litre Two TSB measurements with Trend 12 as

mean GA 39.2 ± 1.4 weeks threshold
Gender: Males = 56.4% Sensitivity: 85/85 (100%)
ethnicity: Not reported Specificity: 217/429 (50.6%)
PPV: 85/302 (28.6%)
NPV: 217/217 (100%)
Hospital B: +LR: 2.0
n = 498,
mean BW 3312 ± 394 g, Two TSB measurements with Trend 15 as
mean GA 39.5 ± 1.3 weeks threshold
Sensitivity: 92/92 (100%)
Gender: Males = 51.8% Specificity: 355/422 (84.1%)
ethnicity: Not reported
PPV: 92/159 (57.9%)
NPV: 355/355 (100%)
+LR: 6.3

HOSPITAL B
Prevalence of TSB > 12 MG/DL
129/498 (25.9%)

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