title: Value of twelfth hour bilirubin level in predicting significant hyperbilirubinemia in preterm infants.
abstract: BACKGROUND
  As hyperbilirubinemia is a significant cause of brain injury, it is important to predict the cases who are at risk. Data for preterm infants are scarce. The aim of this study is to predict significant hyperbilirubinemia in preterm infants by measuring capillary bilirubin at 12th hour of life.
  
  
  METHODS
  One hundred and fifty neonates born ≤ 35 weeks were included in the study. They were categorized into two groups according to their birth weights (group 1: 1,000 - 1,499 g; group 2: 1,500 - 2,000 g). Their bilirubin levels were measured at 12th hour and daily thereafter for 5 days. Risk nomograms were generated based on their bilirubin measurements and postnatal ages. On the age-specific percentile-based nomogram, the zone above the 90th percentile was determined as high risk and those below the fifth percentile as low risk. Infants who had bilirubin levels over the limits defined according to their postnatal ages and birth weights were accepted to have significant hyperbilirubinemia and received phototherapy and predictive value of the 12th hour bilirubin was asssessed.
  
  
  RESULTS
  Fifty-four of 57 infants (94.7%) in group 1 and 75/93 infants (80.7%) in group 2 received phototherapy. Capillary bilirubin levels of 3.55 mg/dL and 4.55 mg/dL for group 1 and group 2 measured at the 12th hour of life had the highest sensitivity, negative and positive predictive value to predict the neonates who will develop significant hyperbilirubinemia.
  
  
  CONCLUSIONS
  Bilirubin levels of preterm infants should be monitored closely. More attention should be paid to the ones who had 12th hour bilirubin level above the cutoff values.
authors.affiliation: Zeynep Kamil Maternity and Children's Research and Training Hospital, Istanbul, Turkey.
authors.forename: Izi
authors.initials: I
authors.lastname: Mayer
authors.affiliation: Zeynep Kamil Maternity and Children's Research and Training Hospital, Istanbul, Turkey.
authors.forename: Tugba
authors.initials: T
authors.lastname: Gursoy
authors.affiliation: Hacettepe University Faculty of Medicine Preventive Oncology, Ankara, Turkey.
authors.forename: Mutlu
authors.initials: M
authors.lastname: Hayran
authors.affiliation: Zeynep Kamil Maternity and Children's Research and Training Hospital, Istanbul, Turkey.
authors.forename: Secil
authors.initials: S
authors.lastname: Ercin
authors.affiliation: Zeynep Kamil Maternity and Children's Research and Training Hospital, Istanbul, Turkey.
authors.forename: Fahri
authors.initials: F
authors.lastname: Ovali
keywords: Hyperbilirubinemia; Neonate; Phototherapy; Preterm
references.citation: Arch Pediatr Adolesc Med. 2002 Dec;156(12):1244-50
references.pmid: 12444838
references.citation: Pediatrics. 1992 May;89(5 Pt 1):826-7
references.pmid: 1579386
references.citation: Indian Pediatr. 2002 Aug;39(8):724-30
references.pmid: 12196683
references.citation: J Perinatol. 1999 Dec;19(8 Pt 1):564-7
references.pmid: 10645520
references.citation: Indian J Pediatr. 1998 Jan-Feb;65(1):131-9
references.pmid: 10771956
references.citation: Pediatrics. 2001 Jul;108(1):31-9
references.pmid: 11433051
references.citation: Pediatrics. 2000 Aug;106(2):E16
references.pmid: 10920172
references.citation: Pediatrics. 2004 Jul;114(1):297-316
references.pmid: 15231951
references.citation: Pediatrics. 1999 Jan;103(1):6-14
references.pmid: 9917432
references.citation: Adv Pediatr. 1997;44:173-229
references.pmid: 9265971
references.citation: N Y State J Med. 1991 Nov;91(11):476-7
references.pmid: 1771040
references.citation: Acta Paediatr. 2005 May;94(5):581-7
references.pmid: 16188747
references.citation: Indian J Pediatr. 2000 Oct;67(10):733-7
references.pmid: 11105424
references.citation: Arch Dis Child Fetal Neonatal Ed. 2003 Nov;88(6):F455-8
references.pmid: 14602689
references.citation: J Perinatol. 2001 Dec;21 Suppl 1:S63-72; discussion S83-7
references.pmid: 11803421