Diagnosis Accuracy of Transcutaneous Bilirubinometry in Very Preterm Newborns

Autor: Sylvain Samperiz, Maya Gebus, Thierry Debillon, Chloé Epiard, Anne Ego, Amandine Rubio, Michel Deiber, Céline Genty
Přispěvatelé: Grenoble Institut des Neurosciences (GIN), Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Grenoble Alpes - UFR Médecine (UGA UFRM), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Centre hospitalier Félix-Guyon [Saint-Denis, La Réunion], Techniques pour l'Evaluation et la Modélisation des Actions de la Santé (TIMC-IMAG-ThEMAS), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Registre des Handicaps de l'Enfant et Observatoire Périnatal Isère, RHEOP
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Male
Time Factors
MESH: Logistic Models
MESH: Phototherapy
chemistry.chemical_compound
0302 clinical medicine
MESH: Bilirubin
MESH: Gestational Age
030212 general & internal medicine
Prospective Studies
Prospective cohort study
Obstetrics
MESH: Infant
Extremely Premature

MESH: Infant
Newborn

Gestational age
Jaundice
MESH: Predictive Value of Tests
3. Good health
Jaundice
Neonatal

Very preterm
Predictive value of tests
Infant
Extremely Premature

Female
France
medicine.symptom
Blood drawing
medicine.medical_specialty
Bilirubin
MESH: Jaundice
Neonatal

education
Gestational Age
MESH: Multivariate Analysis
03 medical and health sciences
Neonatal Screening
Predictive Value of Tests
030225 pediatrics
medicine
Humans
MESH: Neonatal Screening
Transcutaneous bilirubin
MESH: Humans
business.industry
MESH: Time Factors
Infant
Newborn

Phototherapy
MESH: Prospective Studies
MESH: Male
MESH: France
Logistic Models
chemistry
Pediatrics
Perinatology and Child Health

Multivariate Analysis
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
business
MESH: Female
Developmental Biology
Zdroj: Neonatology
Neonatology, Karger, 2016, 111 (1), pp.1-7. ⟨10.1159/000447736⟩
ISSN: 1661-7800
1661-7819
DOI: 10.1159/000447736⟩
Popis: Background: Transcutaneous bilirubin (TcB) is a validated test for systematic screening of neonatal hyperbilirubinemia and monitoring term and near-term infants under phototherapy. Objectives: To evaluate TcB diagnostic accuracy for very preterm neonates. Methods: Total serum bilirubin (TSB) and TcB measurements were performed prospectively in a multicenter sample of newborns Results: Altogether, 481 measurements were analyzed in 167 preterm patients. Mean GA was 27.6 ± 1.6 weeks. The rates of newborns requiring phototherapy were 52% in the first 3 days, 16% from the 4th to the 7th day, and 2% during the second week. Diagnostic performance was similar among babies with or without phototherapy. TcB sensitivity decreased over time from 100% (93.9-100.0) to 50% (1.3-98.7). Specificity showed an inverse evolution from 14.8% (7.0-26.2) to 80.7% (72.2-89.2). The best performance was that of negative predictive values which varied from 95.5 to 100.0. False negatives were rare throughout the study (0.8% of measurements). In a multivariate analysis, the only factor significantly influencing discordance between TcB and TSB was postnatal age. We did not find any impact of GA and skin color. Conclusion: Among very preterm babies, TcB measurements might be useful for screening for neonatal jaundice in the first 2 weeks of life. In case of a TcB value below the phototherapy threshold, invasive TSB quantification could be unnecessary, with potential avoidance of blood drawing.
Databáze: OpenAIRE