title: Validation of transcutaneous bilirubin nomogram for identifying neonatal hyperbilirubinemia in healthy Chinese term and late-preterm infants: a multicenter study.
abstract: OBJECTIVE
  to prospectively validate a previously constructed transcutaneous bilirubin (TcB) nomogram for identifying severe hyperbilirubinemia in healthy Chinese term and late-preterm infants.
  
  
  METHODS
  this was a multicenter study that included 9,174 healthy term and late-preterm infants in eight hospitals of China. TcB measurements were performed using a JM-103 bilirubinometer. TcB values were plotted on a previously developed TcB nomogram, to identify the predictive ability for subsequent significant hyperbilirubinemia.
  
  
  RESULTS
  in the present study, 972 neonates (10.6%) developed significant hyperbilirubinemia. The 40(th) percentile of the nomogram could identify all neonates who were at risk of significant hyperbilirubinemia, but with a low positive predictive value (PPV) (18.9%). Of the 453 neonates above the 95(th) percentile, 275 subsequently developed significant hyperbilirubinemia, with a high PPV (60.7%), but with low sensitivity (28.3%). The 75(th) percentile was highly specific (81.9%) and moderately sensitive (79.8%). The area under the curve (AUC) for the TcB nomogram was 0.875.
  
  
  CONCLUSIONS
  this study validated the previously developed TcB nomogram, which could be used to predict subsequent significant hyperbilirubinemia in healthy Chinese term and late-preterm infants. However, combining TcB nomogram and clinical risk factors could improve the predictive accuracy for severe hyperbilirubinemia, which was not assessed in the study. Further studies are necessary to confirm this combination.
authors: Department of Pediatrics, Nanjing Maternity and Child Health Care Hospital of Nanjing Medical University, Nanjing, China.
authors: Zhangbin
authors: Z
authors: Yu
authors: Department of Pediatrics, Nanjing Maternity and Child Health Care Hospital of Nanjing Medical University, Nanjing, China.
authors: Shuping
authors: S
authors: Han
authors: Department of Neonatology, Inner Mongolia Maternal and Child Health Care Hospital, Huhehot, China.
authors: Jinxia
authors: J
authors: Wu
authors: Department of Neonatology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
authors: Mingxia
authors: M
authors: Li
authors: Department of Neonatology, Changzhou Maternal and Child Health Care Hospital, Changzhou, China.
authors: Huaiyan
authors: H
authors: Wang
authors: Department of Neonatology, Gynecology and Obstetrics Hospital, Fudan University, Shanghai, China.
authors: Jimei
authors: J
authors: Wang
authors: Department of Pediatrics, The Fifth People's Hospital of Shenzhen, Shenzhen, China.
authors: Jiebo
authors: J
authors: Liu
authors: Department of Neonatology, Guangxi Maternal and Child Health Hospital, Nanning, China.
authors: Xinnian
authors: X
authors: Pan
authors: Department of Neonatology, Guangdong Maternal and Children's Hospital, Guangzhou Medical College, Guangzhou, China.
authors: Jie
authors: J
authors: Yang
authors: Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China. Electronic address: chen6010@163.com.
authors: Chao
authors: C
authors: Chen
mesh_terms: D001663:Bilirubin / Q000097:blood*; D002681:China; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006769:Hospitals, General; D006771:Hospitals, Maternity; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000097:blood* / Q000175:diagnosis* / Q000517:prevention & control; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D008297:Male; D049451:Nomograms; D010351:Patient Discharge; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D001663:Bilirubin
keywords: Bilirrubina; Bilirubin; Hiperbilirrubinemia; Hyperbilirubinemia; Icterícia; Jaundice; Neonatal; Neonatos; Newborn