Page 262 - 16Neonatal Jaundice_compressed

Neonatal jaundice

Bibliographic details Study type & Patient characteristics Test, Reference Standard, Results Reviewers Comments
Evidence level Threshold for a positive test
Gender: Not reported nomogram. 54.9)

Ethnicity: Predictive ability of pre-discharge Predictive ability of pre-discharge TcB
White = 59.1% TcB levels (threshold = 75 (threshold = 75th centile) for significant
th
Black = 29.5% centile) evaluated for subsequent hyperbilirubinaemia (n = 419)
Hispanic = 3.5% significant hyperbilirubinaemia
Asian = 4.5% th
Others = 3.5% (defined as TSB = 95 centile or in Sensitivity: 23/23 (100%)
the high-risk zone on the hour- Specificity: 349/396
Exclusion: specific nomogram) (88.1%)
PPV: 23/70 (32.9%)
clinical manifestation of sepsis, heart NPV: 349/349 (100%)
or circulatory disease,
respiratory distress, +LR: 8.4
clinical evidence of
haemoglobinopathy,
initiation of phototherapy.

Newman TB; Study Type: Nested Cohort of all infants with 1) Relationship of clinical and Maternal and prenatal factors associated Unselected population but
case- control study BW = 2000 g and GA = 36 weeks demographic factors associated with significant hyperbilirubinaemia (those exclusion criteria not defined
Year: 2000 born alive at 11 hospitals of a health with hyperbilirubinaemia evaluated with P < 0.05 in bivariate analysis) Confounding variables
Evidence Level: II maintenance organisation during a by bivariate analysis and OR controlled for during
Country: USA two year period (n = 51 387) Maternal factors multivariate analysis
Test & Reference test described
9 Cases: 2) Risk factors significant in the  Race, adequately
Babies with maximum TSB univariate model entered into  maternal age, Reference test a standard test
multiple regression analysis to find

family HISTORY OF jaundice in
levels = 428 micromol/litre within the independent predictors of a newborn, Blinding – Not reported
first 30 days after birth hyperbilirubinaemia – both by  vacuum delivery
n = 73
Mean BW: Not reported including and excluding early
jaundice cases
Mean GA: Not reported Neonatal factors
Gender: Males = 67.1% Early jaundice cases (n = 14)  Male sex,
Ethnicity: Not reported (only maternal defined as babies with TSB  lower GA,
race specified)  early jaundice,
exceeding recommended  cephalohaematoma,
phototherapy threshold for age  bruising,
during birth hospitalisation,
Controls: those given phototherapy during  breastfeeding at time of
Random sample of babies from the birth hospitalisation, discharge
cohort with maximum TSB
levels = 428 micromol/litre when jaundice noted at less than Factors independently associated with
n = 423 20 hours of age and TSB not significant hyperbilirubinaemia from
measured within 6 hours of that
Mean BW: Not reported time. multivariate regression analysis (OR with
Mean GA: Not reported 95% CI)
Gender: Males = 54.4%
Ethnicity: Not reported (only maternal 3) Risk index developed by
race specified) assigning points equal to the OR All cases (n = 73)

for risk factors that were significant
in the logistic regression model Early jaundice: OR 7.3 (2.8–19)
For analyses examining the use of with the exclusion of early jaundice GA (per wk): OR 0.6 (0.4–0.7)
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