Hour-specific nomogram for transcutaneous Bilirubin in newborns in Myanmar

Pediatr Int. 2020 Sep;62(9):1049-1053. doi: 10.1111/ped.14251. Epub 2020 Sep 14.

Abstract

Background: Neonatal hyperbilirubinemia is a significant health problem in Myanmar, and the rate of kernicterus is also higher than in developed countries. Non-invasive methods for early detection and treatment of hyperbilirubinemia are urgently needed. In this study, we used transcutaneous bilirubin (TcB) measurements to develop an hour-specific TcB nomogram for the effective management of hyperbilirubinemia in Myanmar newborns.

Methods: The bilirubin levels of neonates born in Central Women Hospital in Yangon, Myanmar were measured three times a day within 72 h after birth using a transcutaneous bilirubinometer. An hour-specific TcB nomogram was created based on the data.

Results: Participants were 512 infants (287 boys, 225 girls) born in Central Women's Hospital in Yangon. The mean (±SD) gestational age was 38.4 ± 1.2 weeks; birthweight was 3078 ± 412 g. A total of 3,039 plots were obtained, and the TcB nomogram was created with smoothed percentile curves (97.5th, 50th, and 2.5th percentiles) for 0-72 h after birth.

Conclusions: An hour-specific TcB nomogram was successfully created to manage hyperbilirubinemia in Myanmar newborns.

Keywords: Myanmar; hyperbilirubinemia; neonatal jaundice; nomogram; transcutaneous bilirubin.

MeSH terms

  • Bilirubin / analysis*
  • Birth Weight
  • Female
  • Gestational Age
  • Humans
  • Hyperbilirubinemia, Neonatal / diagnosis*
  • Hyperbilirubinemia, Neonatal / therapy
  • Infant, Newborn
  • Kernicterus / diagnosis
  • Longitudinal Studies
  • Male
  • Myanmar
  • Neonatal Screening / methods*
  • Nomograms*
  • Risk Factors
  • Sensitivity and Specificity
  • Skin / metabolism
  • Time Factors

Substances

  • Bilirubin