Abstract
Aim of the study: To establish predictive criteria of neonatal hyperbilirubinemia in ABO incompatibility.
Method: 668 healthy full-term newborns with ABO incompatibility were initially enrolled in the prospective cohort study.
Results: Hyperbilirubinemia was diagnosed to 71(10.6 %) newborns. Positive direct Coombs' test (DCT) was diagnosed significantly more often to newborns with hyperbilirubinemia, even 85.5% newborns of this group had negative DCT. Total serum bilirubin (TSB) level cut-off point at the 6 hour of life was 76.0 µmol/L (sensitivity 0.9, specificity 0.9) i.e. 9.7% in healthy group and 87.3% (P< 0.001) of newborns with hyperbilirubinemia had TSB 76.0 µmol/L. According to the determined value, it can be predicted that newborns with TSB level >76 µmol/L at the age of 6 hours will have hyperbilirubinemia with an odds ratio of 64.0[30.2-135.5]. With a ROC curve hemocrit cut-off point 44% was determined (sensitivity 0.5; speificity 0.5). The cut-off point of reticulocytes was determined to be 4.8% (sensitivity 0.8, specificity 0.7). Binary logistic regression analysis model allows to predict that newborns will have a higher odds ratio to be diagnosed with hyperbilirubinemia (47.5[20.4-110.4]), when TSB at the 6 hour of life is >76 µmol/L, 3.0[1.4-6.4], reticulocytes >4.8%, 6.0[2.8-12.7], hematocrit < 44%, 2.6[1.0-7.3], spehrocytes >1.5 (units), positive DCT (1.7[0.6-4.8]).
Conclusions: The most significant factor in predicting ABO hyperbilirubinemia is TSB at the age of 6 hours >76 µmol/L. The prognostic value of the hematocrit and reticulocytes level in blood was lower. The number of spherocytes in blood and DCT has no prognostic value.
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Stoniene, D., Buinauskiene, J., Markuniene, E. et al. The Value of Diagnostic Tests in Predicting Hyperbilirubinemia in ABO Incompatibility. Pediatr Res 70 (Suppl 5), 735 (2011). https://doi.org/10.1038/pr.2011.960
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DOI: https://doi.org/10.1038/pr.2011.960