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Sixth-Hour Trancutaneous Bilirubin and Need for Phototherapy in DAT Positive Newborns.
- Source :
-
Pediatrics . Mar2022, Vol. 149 Issue 3, p1-9. 9p. - Publication Year :
- 2022
-
Abstract
- OBJECTIVES: To characterize the outcomes of ABO incompatible direct antiglobulin test (DAT) positive newborns and determine the predictive ability of a sixth-hour transcutaneous bilirubin (TcB for needing phototherapy #24 hours of age. METHODS: Retrospective, cross-sectional study from May 2013 to March 2017. Of 10 942 consecutive newborns $35 weeks estimated gestational age, 829 were ABO incompatible and DAT positive. After excluding for antibodies other than ABO (51), missing data (4), miscategorization of blood type O (1), and duplicate record (1), 772 newborns remained. Of 772, a subsample of 346 newborns with both TcB and total serum bilirubin (TSB) tests within 1 hour of the sixth hour was analyzed to determine the predictive ability. RESULTS: Phototherapy was required in 281 of 772 (36.4%); 156 (20.2%) in the first 24 hours. There were 10 (1.3%) admissions for hyperbilirubinemia to the NICU for intravenous immunoglobin. Birth weight, infant blood type B, TSB, reticulocyte count, and TcB were all significantly associated with phototherapy #24 hours. On multivariate analysis, significant predictors of phototherapy #24 hours were TSB and reticulocyte count if no TcB was done and TcB alone if no blood tests were done. TcB was highly predictive (odds ratio 3.1, 95% confidence interval: 2.4-4.0) and nearly as accurate as the TSB and reticulocyte count (area under the curve, 0.90 and 0.96, respectively). Low (<3.0 mg/dL) and high ($5.3 mg/dL) risk TcB cutoffs demonstrated a negative predictive value of 98% and positive predictive value of 85%, respectively. CONCLUSIONS: Among high-risk ABO incompatible DAT positive newborns, the sixth-hour TcB is highly predictive of the need for phototherapy #24 hours. [ABSTRACT FROM AUTHOR]
- Subjects :
- *THERAPEUTIC use of immunoglobulins
*ABO blood group system
*IMMUNOGLOBULINS
*RETICULOCYTES
*CONFIDENCE intervals
*PREDICTIVE tests
*NEONATAL jaundice
*PHOTOTHERAPY
*CROSS-sectional method
*GESTATIONAL age
*RETROSPECTIVE studies
*DESCRIPTIVE statistics
*BLOOD cell count
*ODDS ratio
*BILIRUBIN
*CHILDREN
Subjects
Details
- Language :
- English
- ISSN :
- 00314005
- Volume :
- 149
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- 155501409
- Full Text :
- https://doi.org/10.1542/peds.2021-054071