G203(P) The value of transcutaneous bilirubinometery in prediction of the need for phototherapy in preterm infants. (May 2019)

• Record Type: Journal Article
• Authors: Raba, A; O'Sullivan, A; Miletin, J
• Is Part Of: Archives of disease in childhood. Volume 104:(2019)Supplement 2
• Page Start: A82
• Page End: A83
• Publication Date: 2019-05
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2019-rcpch.198
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Background and aims: Transcutaneous bilirubin (TcB) measurement is an effective method for an early diagnosis of neonatal jaundice and prevention of its rapid progression. The aim of our study was to evaluate transcutaneous bilirubinometer as a screening tool (at 24 and 48 hours of age) for the need of phototherapy in preterm infants. Methods: A single centre prospective cohort study conducted in the Coombe Women and Infants University Hospital, Dublin, Ireland (level III perinatal centre). The study included preterm infants (23 +0 to 36 +6 weeks of gestation) born between June 2017 and May 2018. TcB was measured in all enrolled infants at 24 hours and 48 hours of postnatal age (using Dräger Jaundice Meter JM-105 or JM-103). Our primary outcome was the prediction value of TcB in relation to the need of phototherapy during hospital admission. Results: A total of 338 preterm infants (mean birth weight(±SD) 2013 g(±693), mean gestational age(±SD) 32.6 (±3.4) weeks of gestation) were enrolled during the study period. One hundred and eighty-one (53.6%) infants developed significant hyperbilirubinemia requiring phototherapy during the study period. Majority of infants (98.1%) below 32 weeks of gestation required phototherapy. We constructed ROC curves for the group of preterm infants born above 31 +6 weeks of gestation. The optimal cut off point for TcB at 24 hours of age was 81 μmol/L (sensitivity 83%; specificity 56%; positive predictive value (PPV) 54.7%; negative predictive value (NPV) 84%). The optimal cut off point for TcB at 48 hours of age was 145 μmol/L (sensitivity 65%; specificity 62%; PPV 24%; NPV 90%). Conclusion: TcB performed poorly as a predictor of phototherapy at 24 and 48 hours of age in preterm infants. However, the negative predictive values of the test can be helpful to identify infants who are at the low risk of developing significant hyperbilirubinemia.