Transcutaneous bilirubin levels in healthy term and late preterm Indian neonates.
OBJECTIVE
To provide normative data for transcutaneous bilirubin (TcB) measurements in healthy term and late-preterm Indian neonates during first 72 h of age using a multiwavelength reflectance transcutaneous bilimeter.


METHODS
TcB measurements were performed in healthy neonates (gestation 35 wk), in a well-baby ward, using a multiwavelength transcutaneous bilimeter (BiliCheck, SpectRx Inc, Norcross, GA). Age-specific percentiles values for each 6-h epoch starting at 0 h of age were calculated and an age-specific TcB nomogram was developed using different percentile values. Diagnostic ability of each percentile curve for prediction of hyperbilirubinemia, defined as requirement of phototherapy, was calculated.


RESULTS
We performed 925 TcB measurements on 625 healthy newborn infants (gestation: 35 to 41 wk; age: 0 to 72 h; mean birth weight: 2808+/-437 g). TcB increased in a linear manner with maximum rate of rise observed during first 24 h of age (50th percentile: 0.22 mg/dL/h). 50th percentile curve of age-specific TcB nomogram had high negative predictive value (99.8%) and acceptable positive predictive value (16.4%) for prediction of hyperbilirubinemia.


CONCLUSIONS
We provided age-specific nomogram of TcB for first 72 h of age in healthy term and late-preterm Indian neonates. Percentile curves and rate of rise in TcB may help in identification of neonates at low-risk of development of hyperbilirubinemia facilitating their safer discharge from the hospital. Diagnostic utility of this nomogram for predicting hyperbilirubinemia needs to be tested in a separate validation cohort.
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Satish
S
Mishra
Deepak
D
Chawla
Ramesh
R
Agarwal
Ashok Kumar
AK
Deorari
Vinod Kumar
VK
Paul
D001663:Bilirubin / Q000378:metabolism*; D006304:Health Status; D006801:Humans; D006932:Hyperbilirubinemia / Q000453:epidemiology* / Q000378:metabolism* / Q000628:therapy; D007194:India / Q000453:epidemiology; D007231:Infant, Newborn; D007234:Infant, Premature; D010789:Phototherapy / Q000379:methods; D011446:Prospective Studies; D012867:Skin / Q000378:metabolism*
D001663:Bilirubin