PROBABILITY OF SUBSEQUENT HYPERBILIRUBINEMIA IN TERM HEALTHY NEWBORNS WITH NO ABO/Rh DISEASE. † 1165

Term healthy newborns with no ABO or Rh hemolytic disease but with significant hyperbilirubinemia (high bili, >17mg/dl) are an extraordinary segment of the population. We assessed the risk of high bili as predicted by bili measurements at 24° and 48° age in 1140 newborns consecutively discharged at ≈24° age. Bili values were measured before discharge at age 20°-28° (extrapolated to 24°) and at ≈48°, days 3 and 4 and as needed therafter. 51/1140 of these (5.1%) developed high bili. The predictive ability of a bili value at 24° age was determined in a representative subset population (n=243) by its sensitivity (Sens%) and specificity (Spec%). The probability (Prob%) and likelihood ratio (LR) of manifesting high bili were also calculated. Thus, it is feasible to recommend a modified program of routine bili reassessment by a post early discharge community based follow-up program that provides home visits by a trained neonatal nurse. This would include lactational support, a visual check for jaundice for babies with 24° bili of <5.0 with optional bili sampling and a mandatory bili check for that select group of babies with day #1 bili>5.0. Babies with bili >8.0 at day #1 need comprehensive hospital based evaluation. The predictive ability of bili at age 24° needs confirmation in a larger sample size. Table

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Bhutani, V., Johnson, L. PROBABILITY OF SUBSEQUENT HYPERBILIRUBINEMIA IN TERM HEALTHY NEWBORNS WITH NO ABO/Rh DISEASE. † 1165. Pediatr Res 39, 197 (1996). https://doi.org/10.1203/00006450-199604001-01187

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