title: Sixth hour transcutaneous bilirubin predicting significant hyperbilirubinemia in ABO incompatible neonates.
abstract: BACKGROUND
  Neonates with ABO hemolytic disease are at greater risk for developing significant hyperbilirubinemia. We aimed to determine whether sixth hour transcutaneous bilirubin (TcB) could predict such a risk.
  
  
  METHODS
  TcB measurements were obtained at the 6th hour of life in blood group A or B neonates born to blood group O, rhesus factor compatible mothers. Subsequent hyperbilirubinemia was monitored and considered significant if a neonate required phototherapy/exchange transfusion. The predictive role of sixth hour TcB was estimated.
  
  
  RESULTS
  Of 144 ABO incompatible neonates, 41(OA, 24; O-B, 17) had significant hyperbilirubinemia. Mean sixth hour TcB was significantly higher among neonates who developed significant hyperbilirubinemia than those who did not (5.83±1.35 mg/dL vs. 3.65±0.96 mg/dL, P<0.001). Sixth hour TcB value >4 mg/dL had the highest sensitivity of 93.5% and >6 mg/dL had the highest specificity of 99%. Area under receiver operating characteristic curve was 0.898.
  
  
  CONCLUSIONS
  Sixth hour TcB predicts subsequent significant hyperbilirubinemia in ABO incompatible neonates.
authors.affiliation: Department of Pediatrics, Kasturba Medical College, Manipal University, Manipal, 576104, Udupi District, Karnataka, India, docrameshbhat@yahoo.co.in.
authors.forename: Ramesh Y
authors.initials: RY
authors.lastname: Bhat
authors.forename: Pavan C G
authors.initials: PC
authors.lastname: Kumar
mesh_terms: D000017:ABO Blood-Group System; D005260:Female; D006801:Humans; D006932:Hyperbilirubinemia / Q000175:diagnosis*; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D000017:ABO Blood-Group System