Share This Article:

Percentile analysis of plasma total bilirubin—How different will the rate of phototherapy for jaundice of neonates be by different standards?

Abstract Full-Text HTML Download Download as PDF (Size:253KB) PP. 133-137
DOI: 10.4236/ojped.2012.22022    3,948 Downloads   6,933 Views   Citations

ABSTRACT

Phototherapy of a jaundiced neonate is usually started when bilirubin exceeds a threshold in the standard. There are several standards used in the developed countries even though the guideline of American Academy of Pediatrics is considered to be a global standard. Although the purpose of phototherapy is the prevention of kernicterus, nowadays the prevalence of kernicterus in otherwise healthy term neonates in the developed countries is rare. Meanwhile several potential adverse effects of phototherapy have been reported. In the present study we tried to estimate how different the rate of phototherapy for the jaundice of neonates at lower risk of kernicterus would be by different standards. For this purpose, we utilized the records of plasma total bilirubin (TB) values of 1893 healthy neonates of 38 weeks and more which were measured on day 6 for the percentile analysis. However, this database did not include the TB values of the neonates who received phototherapy by day 6. Then the database was corrected with an assumption that TB on day 6 would have been normally distributed if no phototherapy had been performed. The mean and the standard deviation (SD) of corrected database were 11.29 mg/dl (193 μmol/l) and 3.63 mg/dl (62 μmol/l), respectively. Using a standard distribution with these mean and SD, the percents of TB values which exceed 18.0, 19.0, 20.0 and 21.0 mg/dl on day 6 were estimated 3.22%, 1.70%, 0.82% and 0.35%, respectively. Results of the present report would help to estimate the relative rate of phototherapy that is performed for the neonates who are term and otherwise healthy by different standards.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Nagao, Y. , Watanabe, H. and Yokota, S. (2012) Percentile analysis of plasma total bilirubin—How different will the rate of phototherapy for jaundice of neonates be by different standards?. Open Journal of Pediatrics, 2, 133-137. doi: 10.4236/ojped.2012.22022.

References

[1] Hansen, T.W. (1996) Therapeutic approaches to neonatal jaundice: An international survey. Clinical Pediatrics, 35, 309-316. doi:10.1177/000992289603500604
[2] Kaplan, M., Merlob, P. and Regev, R. (2008) Israel guidelines for the management of neonatal hyperbilirubinemia and prevention of kernicterus. Journal of Perinatology, 28, 389-397. doi:10.1038/jp.2008.20
[3] Horn, A.R., Kirsten, G.F., Kroon, S.M., Henning, P.A., et al. (2006) Phototherapy and exchange transfusion for neonatal hyperbilirubinemia: Neonatal academic hospitallas’ consensus guidelines for South Africa hospitals and primary care facilities. South African Medical Journal, 96, 819-824.
[4] The Canadian Paediatric Society (1999) Hyperbilirubinemia in term newborn infants. Canadian Family Physician, 45, 2690-2692.
[5] Rennie, J., Burman-Roy, S., Murphy, M.S. and Guideline Developmental Group (2010) Neonatal jaundice: Summary of NICE guidance. British Medical Journal, 340, c2409. doi:10.1136/bmj.c2409
[6] American Academy of Pediatrics Subcommittee on Hyperbilirubinemia (2004) Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics, 114, 297-316. doi:10.1542/peds.114.1.297
[7] Department of Pediatrics, Kobe University (1993) Management of premature and newborn infants. Nihon Iji Shuppan, Tokyo, 205-222.
[8] Murata, F. (1981) Exchange transfusion and phototherapy. Syusanki Igaku, 11, 2059-2061.
[9] Igarashi, T. (2005) Manual for pediatric diseases. Chugai Igaku Sha, Tokyo, 564-567.
[10] Maisels, M.J. and McDonagh, A.F. (2008) Phototherapy for neonatal jaundice. New England Journal of Medicine, 358, 920-928. doi:10.1056/NEJMct0708376
[11] Eggert, L.D., Wiedmeier, S.E., Wilson, J. and Christensen, R.D. (2006) The effect of instituting a prehospital-discharge newborn bilirubin screening program in an 18-hospital health system. Pediatrics, 117, e855-e862. doi:10.1542/peds.2005-1338
[12] Bhutani, V.K., Johnson, L.H., Schwoebel, A. and Gennaro, S. (2006) A systems approach for neonatal hyperbilirubinemia in term and nearterm newborns. Journal of Obstetric, Gynecologic & Neonatal Nursing, 35, 444-455. doi:10.1111/j.1552-6909.2006.00044.x
[13] Maisels, M.J. and Kring, E.A. (1998) Length of stay, jaundice, and hospital readmission. Pediatrics, 101, 995-998. doi:10.1542/peds.101.6.995
[14] Walsh, S.A. and Murphy, J.F. (2010) Neonatal jaundice—Are we over-treating? Irish Medical Journal, 103, 28-29.
[15] Dobson, V. (1976) Editorial: Phototherapy and retinal damage. Investigative Ophthalmology, 15, 595-598.
[16] Siegfried, E.C., Stone, M.S. and Madison, K.C. (1992) Ultraviolet light burn: A cutaneous complication of visible light phototherapy of neonatal jaundice. Pediatric Dermatology, 9, 278-282. doi:10.1111/j.1525-1470.1992.tb00348.x
[17] Csoma, Z., Hencz, P., Orvos, H., Kemeny, L., et al. (2007) Neonatal blue-light phototherapy could in-crease the risk of dysplastic nevus development. Pediatrics, 119, 1036-1037. doi:10.1542/peds.2007-0180
[18] Tatli, M.M., Minnet, C., Kocyigit, A. and Karadag, A. (2008) Phototherapy increases DNA damage in lymphocytes of hyperbilirubinemic neonates. Mutation Research, 654, 93-95.
[19] Maisels, M.J. (2010) Screening and early postnatal management strategies to prevent hazardous hyperbilirubinemia in newborns of 35 or more weeks of gestation. Seminar in Fetal & Neonatal Medicine, 15, 129-135. doi:10.1016/j.siny.2009.10.004
[20] Bratlid, D. (2001) Criteria for treatment of neonatal jaundice. Journal of Perinatology Supplement, 1, S88-S92. doi:10.1038/sj.jp.7210656
[21] Bratlid, D., Nakstad, B. and Hansen, T.W. (2011) National guidelines for treatment of jaundice in the newborn. Acta Paediatrica, 100, 499-505. doi:10.1111/j.1651-2227.2010.02104.x

  
comments powered by Disqus

Copyright © 2019 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.