Princess Amalia Children's Center, Isala, Dokter van Heesweg 2, 8025 AB, PO Box 10400, Zwolle 8000 GK, The Netherlands.
Early Hum Dev. 2021 Sep;160:105418. doi: 10.1016/j.earlhumdev.2021.105418. Epub 2021 Jun 30.
The cephalocaudal progression in neonatal jaundice is a well-known phenomenon. Since transcutaneous bilirubin measurements (TcB) are increasingly applied, for which different body site can be used, we aimed to quantify the cephalocaudal progression of neonatal jaundice through TcB and to assess the influence of gestational age, postnatal age and the degree of hyperbilirubinemia on this cephalocaudal progression.
In jaundiced neonates ≥32 weeks of gestational age, TcB was measured on 5 sites: forehead, sternum, hipbone, proximal tibia and foot, during the first two weeks of life.
58 neonates were included. Mean ratios of TcB on the 5 sites compared to the forehead were: sternum 1,03 (SD 0,14), hipbone 0,80 (SD 0,16), proximal tibia 0,63 (SD 0,14) and foot 0,44 (SD 0,15). Gestational age, postnatal age nor the degree of hyperbilirubinemia were associated with the cephalocaudal progression (ANOVA p > 0,05).
The cephalocaudal progression of neonatal jaundice is evident, with caudal levels of TcB being less than half of cephalic measurements. This implicates that TcB measurements caudal from the sternum are less reliable, and should be avoided. The degree of cephalocaudal progression is not associated with gestational or postnatal age, nor with height of bilirubin levels.
新生儿黄疸的头至尾进展是一个众所周知的现象。由于经皮胆红素测量（TcB）的应用越来越多，并且可以使用不同的身体部位，我们旨在通过 TcB 量化新生儿黄疸的头至尾进展，并评估胎龄、出生后年龄和高胆红素血症的程度对这种头至尾进展的影响。
在胎龄≥32 周的黄疸新生儿中，在生命的头两周内，在 5 个部位（前额、胸骨、髋骨、胫骨近端和足部）测量 TcB。
共纳入 58 例新生儿。与前额相比，5 个部位的 TcB 比值平均值为：胸骨 1.03（SD 0.14），髋骨 0.80（SD 0.16），胫骨近端 0.63（SD 0.14）和足部 0.44（SD 0.15）。胎龄、出生后年龄或高胆红素血症程度与头至尾进展均无相关性（方差分析 p>0.05）。
新生儿黄疸的头至尾进展明显，尾部 TcB 水平低于头部测量值的一半。这意味着胸骨以下的 TcB 测量不太可靠，应避免使用。头至尾进展的程度与胎龄或出生后年龄无关，也与胆红素水平的高低无关。
