10.6084/m9.figshare.4535450.v1
Olusanya B.O.
Olusanya
B.O.
Emokpae A.A.
Emokpae
A.A.
Supplementary Material for: Use of Transcutaneous Bilirubin to Determine the Need for Phototherapy in Resource-Limited Settings
Karger Publishers
2017
Developing countries
Phototherapy
Neonatal hyperbilirubinemia
Transcutaneous bilirubin
2017-01-10 12:38:17
Dataset
https://karger.figshare.com/articles/dataset/Supplementary_Material_for_Use_of_Transcutaneous_Bilirubin_to_Determine_the_Need_for_Phototherapy_in_Resource-Limited_Settings/4535450
<p><b><i>Background:</i></b> Routine and timely determination of total
serum bilirubin (TSB) remains a challenge in many resource-limited
countries with substantial burden of severe neonatal hyperbilirubinemia.
Limited evidence exists on the potential usefulness of transcutaneous
bilirubin (TcB) to identify infants who may require phototherapy based
on possible treatment criteria in such settings. <b><i>Objective:</i></b>
To compare the number of infants requiring phototherapy across
different TSB criteria and determine the predictive performance of TcB
under each criterion. <b><i>Methods:</i></b> Infants with paired TcB and
TSB measurements in a maternity hospital in Lagos, Nigeria, were
assessed for phototherapy based on TSB criteria by the American Academy
of Pediatrics (AAP), National Institute for Health and Clinical
Excellence (NICE) UK, and World Health Organization (WHO), and an
absolute threshold of ≥12 mg/dL. The predictive performance of TcB
across treatment criteria was evaluated with receiver operating curve
analysis. <b><i>Results:</i></b> A total of 1,011 infants with a mean
TcB of 10.54 ± 3.19 (range: 2.7-19.9) mg/dL and TSB of 9.63 ± 2.61
(range: 0.3-19.5) mg/dL were assessed. Some 60 (5.9%) infants required
phototherapy by 1 or more TSB criteria, with TSB ≥12 mg/dL identifying
55 (91.7%) and AAP 27 (45%) of these infants. All infants identified by
the NICE and WHO criteria were equally detected by the AAP criterion.
TcB showed negative predictive values of 99.0-99.9%, and positive
predictive values of 7.7-15.5% across all criteria. <b><i>Conclusions:</i></b>
The number of infants requiring phototherapy varies significantly
across treatment criteria. TcB may be useful in identifying infants who
do not require phototherapy, but may also identify a high proportion of
false positives that is burdensome in resource-limited settings.</p>