Development and validation of serum bilirubin nomogram to predict the absence of risk for severe hyperbilirubinaemia before discharge: a prospective, multicenter study

作者：Romagnoli Costantino; Tiberi Eloisa; Barone Giovanni; De Curtis Mario; Regoli Daniela; Paolillo Piermichele; Picone Simonetta; Anania Stefano; Finocchi Maurizio; Cardiello Valentina; Giordano Lucia; Paolucci Valentina; Zecca Enrico^*

来源：Italian Journal of Pediatrics, 2012, 38(1): 6.

DOI：10.1186/1824-7288-38-6

• newborn babies
• hyperbilirubinemia
• jaundice
• predictive nomogram

Background: Early discharge of healthy late preterm and full term newborn infants has become common practice because of the current social and economic necessities. Severe jaundice, and even kernicterus, has developed in some term infants discharged early. This study was designed to elaborate a percentile-based hour specific total serum bilirubin (TSB) nomogram and to assess its ability to predict the absence of risk for subsequent non physiologic severe hyperbilirubinaemia before discharge. %26lt;br%26gt;Methods: A percentile-based hour-specific nomogram for TSB values was performed using TSB data of 1708 healthy full term neonates. The nomogram%26apos;s predictive ability was then prospectively assessed in five different first level neonatal units, using a single TSB value determined before discharge. %26lt;br%26gt;Results: The 75th percentile of hour specific TSB nomogram allows to predict newborn babies without significant hyperbilirubinemia only after the first 72 hours of life. In the first 48 hours of life the observation of false negative results did not permit a safe discharge from the hospital. %26lt;br%26gt;Conclusion: The hour-specific TSB nomogram is able to predict all neonates without risk of non physiologic hyperbilirubinemia only after 48 to 72 hours of life. The combination of TSB determination and risk factors for hyperbilirubinemia could facilitate a safe discharge from the hospital and a targeted intervention and follow-up.

• 出版日期2012-2-1