Madlon-Kay Diane J
Famsey Family & Community Medicine Residency Program, 860 Arcade St., St. Paul, MN 55106, USA.
J Fam Pract. 2002 May;51(5):445-8.
To determine whether mothers can accurately assess the presence and severity of jaundice in their newborns, both visually and with an icterometer, after hospital discharge.
Mothers were taught how to examine their infants for jaundice by determining the extent of caudal progression of jaundice and by using an Ingram icterometer. The mothers documented the examinations for 7 days after discharge. Home health nurses examined the babies for jaundice after discharge and obtained serum bilirubin levels.
Mothers of infants cared for in the normal newborn nursery of a 340-bed community hospital.
Maternal assessment of the presence of jaundice and its caudal progression.
Jaundice extending below the nipple line had a positive predictive value of 55% and a negative predictive value of 86% for identifying infants with bilirubin levels of = 12 mg/dL. Icterometer readings of = 2.5 had a positive predictive value of 44% and a negative predictive value of 87% for identifying infants with bilirubin levels of = 12 mg/dL. The 3 infants with bilirubin levels = 17 mg/dL were recognized by their mothers as having jaundice below the nipple line and had icterometer readings of = 2.5.
Further study is needed to determine the optimum method of parental education about newborn jaundice. However, maternal use of the Ingram icterometer and determination of jaundice in relation to the infant's nipple line are both potentially useful methods of assessing jaundice after hospital discharge.
确定母亲在出院后能否通过视觉及经皮黄疸仪准确评估新生儿黄疸的存在及严重程度。
教导母亲如何通过确定黄疸的尾部进展程度及使用英格拉姆经皮黄疸仪来检查婴儿是否患有黄疸。母亲在出院后7天记录检查情况。家庭健康护士在出院后检查婴儿是否患有黄疸并获取血清胆红素水平。
在一家拥有340张床位的社区医院正常新生儿保育室接受护理的婴儿的母亲。
母亲对黄疸存在情况及其尾部进展的评估。
对于识别胆红素水平≥12mg/dL的婴儿，黄疸延伸至乳头线以下的阳性预测值为55%，阴性预测值为86%。经皮黄疸仪读数≥2.5对于识别胆红素水平≥12mg/dL的婴儿，阳性预测值为44%，阴性预测值为87%。3名胆红素水平≥17mg/dL的婴儿被其母亲识别为乳头线以下有黄疸，经皮黄疸仪读数≥2.5。
需要进一步研究以确定关于新生儿黄疸的最佳家长教育方法。然而，母亲使用英格拉姆经皮黄疸仪以及根据婴儿乳头线确定黄疸情况都是出院后评估黄疸的潜在有用方法。
