Michael Kaplan1, M Jeffrey Maisels2. 1. Emeritus, Department of Neonatology, Shaare Zedek Medical Center; Faculty of Medicine, The Hebrew University, Jerusalem, Israel. mkaplan@mail.huji.ac.il. 2. Department of Pediatrics, Beaumont Children's, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA.
Abstract
BACKGROUND AND OBJECTIVE: Due to selection bias and other issues, the only available serum bilirubin-based nomogram does not reflect the natural history of early neonatal bilirubinemia. Our objective was to obtain a global picture of the natural history of early post-natal bilirubin trajectories. STUDY DESIGN: We pooled readings from 19 published transcutaneous bilirubin nomogram reports including many newborns at multiple sites. We constructed a universal transcutaneous bilirubin nomogram which included the 25th, 50th, 75th, and 95th percentiles from 12 to 120 h. RESULTS: The global transcutaneous bilirubin nomogram included >119,000 readings from 44,392 apparently normal, predominantly breastfed newborns ≥35 weeks gestation. The pooled transcutaneous bilirubin trajectories increased during the first 3 post-natal days, and peaked or plateaued between the 3rd and 4th days. CONCLUSIONS: We provide the first globally derived transcutaneous bilirubin nomogram that reflects the natural history of early neonatal bilirubinemia in neonates ≥35 weeks gestation.
BACKGROUND AND OBJECTIVE: Due to selection bias and other issues, the only available serum bilirubin-based nomogram does not reflect the natural history of early neonatal bilirubinemia. Our objective was to obtain a global picture of the natural history of early post-natal bilirubin trajectories. STUDY DESIGN: We pooled readings from 19 published transcutaneous bilirubin nomogram reports including many newborns at multiple sites. We constructed a universal transcutaneous bilirubin nomogram which included the 25th, 50th, 75th, and 95th percentiles from 12 to 120 h. RESULTS: The global transcutaneous bilirubin nomogram included >119,000 readings from 44,392 apparently normal, predominantly breastfed newborns ≥35 weeks gestation. The pooled transcutaneous bilirubin trajectories increased during the first 3 post-natal days, and peaked or plateaued between the 3rd and 4th days. CONCLUSIONS: We provide the first globally derived transcutaneous bilirubin nomogram that reflects the natural history of early neonatal bilirubinemia in neonates ≥35 weeks gestation.
Authors: M Jeffrey Maisels; Vinod K Bhutani; Debra Bogen; Thomas B Newman; Ann R Stark; Jon F Watchko Journal: Pediatrics Date: 2009-09-28 Impact factor: 7.124
Authors: James A Taylor; Anthony E Burgos; Valerie Flaherman; Esther K Chung; Elizabeth A Simpson; Neera K Goyal; Isabelle Von Kohorn; Nui Dhepyasuwan Journal: Pediatrics Date: 2015-01-19 Impact factor: 7.124