Validation of an hourly transcutaneous bilirubin nomogram in a population of term or late preterm newborn infants: preliminary results

Objective: The aim of this study was to asses the validity of the TCB nomogram for the European population for predicting significant hyperbilirubinemia in healthy term and late-preterm newborns.

Methods: This observational study was conducted from February 2009 to December 2009 in the well-baby nurseries of Gemelli hospital of Rome. The predictive ability of the skin bilirubin (TCB) nomogram was prospectively assessed in 926 neonates with gestational age ?35 weeks. TCB was measured with Bilichek and total serum bilirubin (TSB) was contemporary assayed by the standard spectrophotometric method. Every neonate was assess for a single TCB and TSB value.

Results: The mean TSB values was 8.2 +/- 3.2 mg/dl, while the mean TCB values was 9.5 +/- 3.6 mg/dl A sensitivity of 100% and a negative predictive value of 100% were obtained with a single bilirubin determination applying the 75 degrees percentile of our nomogram.

Conclusions: The 75 degrees percentile of the skin bilirubin nomogram for the European population in the first 96 hours of life is able to predict all neonates at risk of severe hyperbilirubinemia. It could facilitate a safe discharge from the hospital and a targeted intervention and follow-up reducing the need for blood samples.