Prasarnphanich Thanong, Somlaw Suporn
Department of Pediatrics, Prapokklao Hospital, Chantaburi 22000, Thailand.
J Med Assoc Thai. 2007 May;90(5):925-30.
To evaluate the clinical value and the predictive usefulness of the routine pre-discharge bilirubin screening in term newborn at 48-72 hours after birth.
Blood samples of 1983 healthy term newborns for measuring total serum bilirubin level were drawn at the same time as the routine metabolic screening at Prapokklao Hospital. Newborns with total serum bilirubin levels > or = 5 mg/dL in the first 24 hours, > or = 10 mg/dL at 25 to 48 hours, > or = 13 mg/dL at 49-72 hours, and > or = 15 mg/dL at > 72 were defined to have hyperbilirubinemia and were started on phototherapy.
Two hundred and seventy-nine newborns (14.07%) with hyperbilirubinemia, including seven (0.35%) with severe hyperbilirubinemia were detected by the bilirubin screening program. Newborns without hyperbilirubinemia at the time of screening test were unlikely to develop subsequent significant hyperbilirubinemia. The costs for detecting hyperbilirubinemia and severe hyperbilirubinemia were 6.22 US$ and 247.87 US$ per case, respectively.
The bilirubin screening program was cost-effective and could detect a number of unexpected severe hyperbilirubinemia. Newborns without hyperbilirubinemia were unlikely to develop subsequent significant hyperbilirubinemia.
评估出生后48 - 72小时足月儿常规出院前胆红素筛查的临床价值及预测效用。
在普拉波克拉奥医院进行常规代谢筛查的同时，采集1983例健康足月儿的血样以测定血清总胆红素水平。血清总胆红素水平在出生后24小时内≥5mg/dL、25至48小时内≥10mg/dL、49 - 72小时内≥13mg/dL以及72小时后≥15mg/dL的新生儿被定义为患有高胆红素血症，并开始接受光疗。
通过胆红素筛查项目检测出279例（14.07%）高胆红素血症新生儿，其中7例（0.35%）为重度高胆红素血症。筛查时无高胆红素血症的新生儿随后发生显著高胆红素血症的可能性较小。检测高胆红素血症和重度高胆红素血症的成本分别为每例6.22美元和247.87美元。
胆红素筛查项目具有成本效益，能够检测出一些意外的重度高胆红素血症。无高胆红素血症的新生儿随后发生显著高胆红素血症的可能性较小。
