Jaundice characteristics of term and near-term newborns and bilirubin nomogram based on transcutaneous measurements

Hyperbilirubinemia is a matter of great concern in neonates as it is commonlyencountered and carries the risks of permanent brain damage and kernicterus. Kernicteruscan be prevented with early diagnosis and interventions. To aid identifying neonates at riskfor kernicterus, pre-discharge screening strategies have been advocated in many centers.Bilirubin nomograms based on serum and transcutaneous measurements and clinical riskfactor assessment are the methods most commonly used.This study is carried out by analyzing demographic and jaundice characteristics andtotal serum and transcutaneous bilirubin measurements during first week of 1251 neonate tobe born in GUTF hospital.In our study, with comparison of demographic characteristics and hyperbilirubinemiaratios of neonates we found that gestational age and birth weight were related withhyperbilirubinemia. Correlation coefficient (r) between transcutaneous bilirubin measuredfrom sternum and total serum bilirubin was found 0.890 (p<0.05). However at high bilirubinlevels, consistant with previous reports, the power of correlation was poor. According to ournomogram, bilirubin measurement within high and low risk zone in first 3 days, were found tobe related with significant hyperbilirubinemia ratios of 46.5% and 1.3% respectively.In conclusion, in the routine care of neonates transcutaneous bilirubin measurementshould be used as a first method for bilirubin testing. But in case of high bilirubin levels, atwhich it is important to decide whether to treat or follow up, it should be better to performserum bilirubin measurement. We suggest that the neonates with bilirubin measurementwithin high risk zone according to nomogram based on transcutaneous measurements,gestational age below 38 weeks (near-term) and neonate with low birth weight should befollowed more closely.