Engle William D, Lai Susanna, Ahmad Naveed, Manning M Denise, Jackson Gregory L
Department of Pediatrics, The University of Texas Southwestern Medical Center, Dallas, Texas 75390-9063, USA.
Am J Perinatol. 2009 Jun;26(6):425-30. doi: 10.1055/s-0029-1214238. Epub 2009 Mar 4.
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 >or= 35 weeks and body weight >or= 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 >or= 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.
我们试图确定西班牙裔新生儿出生后72小时内特定时段经皮胆红素(TcB)测量值的百分位数。纳入胎龄≥35周且体重≥2100g的新生儿。所有新生儿由护理人员至少每24小时用JM - 103测量一次TcB,仅分析出生后10至74小时的西班牙裔新生儿的TcB值。确定了第5、25、50、75和95百分位数曲线。将这些数据与先前发表的主要由非西班牙裔白人新生儿组成的TcB列线图进行比较。在2005名新生儿中总共测量了3284个TcB值。为这个纯西班牙裔人群构建了一个列线图,确定了第5、25、50、75和95百分位数曲线。24、48和72小时的第95百分位数分别为7.6、11.0和12.4mg/dL。我们的结果与先前发表的研究结果比较表明,两个研究人群之间存在虽小但一致的差异,在大多数分析的时间点,西班牙裔新生儿的TcB值显著更高。尽管西班牙裔人群中胎龄≥40周的新生儿比例更高(p<0.001)且纯母乳喂养的比例更低(p<0.001),但仍观察到这些差异。虽然某些人群胆红素水平较高已有充分记录,但西班牙裔新生儿的这种差异尚未得到证实。本文给出了西班牙裔新生儿的TcB列线图,作为一种有助于临床医生管理该人群黄疸的工具。与先前的研究相比,本报告表明,尽管差异相对较小,但在西班牙裔人群中观察到TcB值显著更高。