Gestational Age-Specific Nomogram of Transcutaneous Bilirubin in First 120 h of Life for Term and Late Preterm Indian Neonates. (6th June 2022)

• Record Type: Journal Article
• Authors: Shaw, Subhash Chandra; Negi, Vandana; Bhat, Vivek; Kumar, Ashutosh; Joshi, Rajneesh K; Venkatnarayan, Kannan; Gupta, Rakesh; Kunwar, Bishwo Raj Bdr; Gopalakrishnan, Shridhar; Tewari, Vishal Vishnu; Kanitkar, Madhuri
• Is Part Of: Journal of tropical pediatrics. Volume 68:Number 4(2022)
• Publication Date: 2022-06-06
• Subjects: bilirubin nomogram -- neonatal hyperbilirubinaemia -- neonatal jaundice -- transcutaneous bilirubin; Pediatrics -- Periodicals; Tropical medicine -- Periodicals; Pediatrics -- Periodicals; Tropical Medicine -- Periodicals; Environmental Health -- Periodicals; Infant; Child; 618.929883
• DOI: 10.1093/tropej/fmac047
• Languages: English
• ISSNs: 0142-6338

Abstract

Abstract: Objective: To create a nomogram based on transcutaneous bilirubin values (TCB) in first week of life for term and late preterm (>34 weeks) neonates. Methods and design: Prospective longitudinal study. Setting: Four tertiary-care teaching hospitals (one each in eastern and southern India, two in northern India) between February 2019 and March 2020. Participants: A total of 2492 term and late preterm (>34 weeks) neonates. Intervention: Bilirubin was measured by transcutaneous bilirubinometer (Drager JM-105, Germany) in all neonates in pre-specified times of the day, 12 hourly every day since birth till discharge between 48 and 72 h, and data were recorded in epochs of 6 hourly intervals. Post-discharge, all neonates were called for review in next 48 h. Outcome measures: Primary—TCB in first week of life. Secondary—factors having significant association with significant hyperbilirubinaemia requiring phototherapy. Results: Total of 2492 neonates (males 1303 and female 1189), with a total of 14 162 TCB recordings were analysed and mean hourly bilirubin (TCB) at hourly intervals till 120 h and then daily bilirubin values on Days 6 and 7 were tabulated. We have constructed hour-specific bilirubin nomogram with percentiles as per gestational age in term and near-term Indian neonates till 120 h of life. Amongst the known risk factors, delayed cord clamping, primipara and breastfeeding jaundice had significant association for hyperbilirubinaemia needing phototherapy. Conclusions: We have created gestation-specific nomogram of TCB levels in 6 hourly intervals for the first 120 postnatal hours, obtained from a large predominantly breast fed healthy, term and near-term Indian neonates.