Model to Predict Hyperbilirubinemia in Healthy Term and Near-Term Newborns with Exclusive Breast Feeding

The aim of this study was to identify high-risk newborns who will subsequently develop significant hyperbilirubinemia Days 4 to 10 of life by using the clinical data from the first three days of life. Methods: We retrospectively collected exclusively breastfeeding healthy term and near-term newborns...

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Main Authors: Hsin-Chung Huang, Hwai-I Yang, Yu-Hsun Chang, Rui-Jane Chang, Mei-Huei Chen, Chien-Yi Chen, Hung-Chieh Chou, Wu-Shiun Hsieh, Po-Nien Tsao
Format: Article
Language:English
Published: Elsevier 2012-12-01
Series:Pediatrics and Neonatology
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Online Access:http://www.sciencedirect.com/science/article/pii/S187595721200143X
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author Hsin-Chung Huang
Hwai-I Yang
Yu-Hsun Chang
Rui-Jane Chang
Mei-Huei Chen
Chien-Yi Chen
Hung-Chieh Chou
Wu-Shiun Hsieh
Po-Nien Tsao
author_facet Hsin-Chung Huang
Hwai-I Yang
Yu-Hsun Chang
Rui-Jane Chang
Mei-Huei Chen
Chien-Yi Chen
Hung-Chieh Chou
Wu-Shiun Hsieh
Po-Nien Tsao
author_sort Hsin-Chung Huang
collection DOAJ
description The aim of this study was to identify high-risk newborns who will subsequently develop significant hyperbilirubinemia Days 4 to 10 of life by using the clinical data from the first three days of life. Methods: We retrospectively collected exclusively breastfeeding healthy term and near-term newborns born in our nursery between May 1, 2002, to June 30, 2005. Clinical data, including serum bilirubin were collected and the significant predictors were identified. Bilirubin level ≥15mg/dL during Days 4 to 10 of life was defined as significant hyperbilirubinemia. A prediction model to predict subsequent hyperbilirubinemia was established. This model was externally validated in another group of newborns who were enrolled by the same criteria to test its discrimination capability. Results: Totally, 1979 neonates were collected and 1208 cases were excluded by our exclusion criteria. Finally, 771 newborns were enrolled and 182 (23.6%) cases developed significant hyperbilirubinemia during Days 4 to 10 of life. In the logistic regression analysis, gestational age, maximal body weight loss percentage, and peak bilirubin level during the first 72 hours of life were significantly associated with subsequent hyperbilirubinemia. A prediction model was derived with the area under receiver operating characteristic (AUROC) curve of 0.788. Model validation in the separate study (N = 209) showed similar discrimination capability (AUROC = 0.8340). Conclusion: Gestational age, maximal body weight loss percentage, and peak serum bilirubin level during the first 3 days of life have highest predictive value of subsequent significant hyperbilirubinemia. We provide a good model to predict the risk of subsequent significant hyperbilirubinemia.
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spelling doaj-art-864f0b2363d8404f9eee93442782267c2025-08-20T03:09:42ZengElsevierPediatrics and Neonatology1875-95722012-12-0153635435810.1016/j.pedneo.2012.08.012Model to Predict Hyperbilirubinemia in Healthy Term and Near-Term Newborns with Exclusive Breast FeedingHsin-Chung Huang0Hwai-I Yang1Yu-Hsun Chang2Rui-Jane Chang3Mei-Huei Chen4Chien-Yi Chen5Hung-Chieh Chou6Wu-Shiun Hsieh7Po-Nien Tsao8Department of Pediatrics, Taipei City Hospital, Heping FuYou Branch, Taipei, TaiwanMolecular and Genomic Epidemiology Center, China Medical University Hospital, Taichung, TaiwanDepartment of Pediatrics, Buddhist Tzu Chi General Hospital, Hualien, TaiwanDepartment of Pediatrics, Buddhist Tzu Chi General Hospital, Hualien, TaiwanDepartment of Pediatrics, Cardinal Tien Hospital, Yung Ho Branch, TaiwanDepartment of Pediatrics, Taipei City Hospital, Heping FuYou Branch, Taipei, TaiwanDepartment of Pediatrics, Taipei City Hospital, Heping FuYou Branch, Taipei, TaiwanDepartment of Pediatrics, Taipei City Hospital, Heping FuYou Branch, Taipei, TaiwanDepartment of Pediatrics, Taipei City Hospital, Heping FuYou Branch, Taipei, TaiwanThe aim of this study was to identify high-risk newborns who will subsequently develop significant hyperbilirubinemia Days 4 to 10 of life by using the clinical data from the first three days of life. Methods: We retrospectively collected exclusively breastfeeding healthy term and near-term newborns born in our nursery between May 1, 2002, to June 30, 2005. Clinical data, including serum bilirubin were collected and the significant predictors were identified. Bilirubin level ≥15mg/dL during Days 4 to 10 of life was defined as significant hyperbilirubinemia. A prediction model to predict subsequent hyperbilirubinemia was established. This model was externally validated in another group of newborns who were enrolled by the same criteria to test its discrimination capability. Results: Totally, 1979 neonates were collected and 1208 cases were excluded by our exclusion criteria. Finally, 771 newborns were enrolled and 182 (23.6%) cases developed significant hyperbilirubinemia during Days 4 to 10 of life. In the logistic regression analysis, gestational age, maximal body weight loss percentage, and peak bilirubin level during the first 72 hours of life were significantly associated with subsequent hyperbilirubinemia. A prediction model was derived with the area under receiver operating characteristic (AUROC) curve of 0.788. Model validation in the separate study (N = 209) showed similar discrimination capability (AUROC = 0.8340). Conclusion: Gestational age, maximal body weight loss percentage, and peak serum bilirubin level during the first 3 days of life have highest predictive value of subsequent significant hyperbilirubinemia. We provide a good model to predict the risk of subsequent significant hyperbilirubinemia.http://www.sciencedirect.com/science/article/pii/S187595721200143Xhyperbilirubinemianeonateprediction
spellingShingle Hsin-Chung Huang
Hwai-I Yang
Yu-Hsun Chang
Rui-Jane Chang
Mei-Huei Chen
Chien-Yi Chen
Hung-Chieh Chou
Wu-Shiun Hsieh
Po-Nien Tsao
Model to Predict Hyperbilirubinemia in Healthy Term and Near-Term Newborns with Exclusive Breast Feeding
Pediatrics and Neonatology
hyperbilirubinemia
neonate
prediction
title Model to Predict Hyperbilirubinemia in Healthy Term and Near-Term Newborns with Exclusive Breast Feeding
title_full Model to Predict Hyperbilirubinemia in Healthy Term and Near-Term Newborns with Exclusive Breast Feeding
title_fullStr Model to Predict Hyperbilirubinemia in Healthy Term and Near-Term Newborns with Exclusive Breast Feeding
title_full_unstemmed Model to Predict Hyperbilirubinemia in Healthy Term and Near-Term Newborns with Exclusive Breast Feeding
title_short Model to Predict Hyperbilirubinemia in Healthy Term and Near-Term Newborns with Exclusive Breast Feeding
title_sort model to predict hyperbilirubinemia in healthy term and near term newborns with exclusive breast feeding
topic hyperbilirubinemia
neonate
prediction
url http://www.sciencedirect.com/science/article/pii/S187595721200143X
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