An Hour-specific Nomogram for Transcutaneous Bilirubin Values in Term and Late Preterm Hispanic Neonates

 

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ABSTRACT

We sought to determine percentile values for hour-specific transcutaneous bilirubin (TcB) measurements in Hispanic neonates during the first 72 hours of age. Neonates with gestational age ≥ 35 weeks and body weight ≥ 2100 g were included. All neonates were screened with JM-103™ TcB measurements at a minimum of every 24 hours by nursing personnel, and only TcB values obtained in Hispanic neonates with postnatal ages of 10 to 74 hours were analyzed. The 5th, 25th, 50th, 75th, and 95th percentile curves were determined. These data were compared with a previously published TcB nomogram predominantly composed of white, non-Hispanic neonates. A total of 3284 TcB values were measured in 2005 neonates. A nomogram was constructed for this exclusively Hispanic population, identifying the 5th, 25th, 50th, 75th, and 95th percentile curves. The 95th percentile values at 24, 48, and 72 hours were 7.6, 11.0, and 12.4 mg/dL, respectively. The comparison between our results and those of the previously published study indicated that small but consistent differences between the two study populations were apparent, with the Hispanic neonates having significantly higher TcB values at the majority of time points analyzed. These observations were made despite a higher proportion of neonates ≥ 40 weeks' gestation (p < 0.001) and a lower proportion exclusively breast-fed (p < 0.001) in the Hispanic population versus those in the previous study. Although higher bilirubin levels for certain populations are well documented, such differences in Hispanic neonates have not been confirmed. A TcB nomogram for Hispanic neonates is presented as a tool that will aid the clinician in the management of jaundice for this population. Compared with the previous study, this report indicates that although differences were relatively small, significantly higher TcB values were observed in the Hispanic population.

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William D EngleM.D. 

Department of Pediatrics, The University of Texas Southwestern Medical Center

5323 Harry Hines Blvd., Dallas, TX 75390-9063

Email: William.Engle@utsouthwestern.edu