Natural history of early neonatal bilirubinemia: a global perspective.
Journal of Perinatology
BACKGROUND AND OBJECTIVE: Due to selection bias and other issues, the only available serum bilirubin-based nomogram does not reflect the natural history of early neonatal bilirubinemia. Our objective was to obtain a global picture of the natural history of early post-natal bilirubin trajectories.
STUDY DESIGN: We pooled readings from 19 published transcutaneous bilirubin nomogram reports including many newborns at multiple sites. We constructed a universal transcutaneous bilirubin nomogram which included the 25th, 50th, 75th, and 95th percentiles from 12 to 120 h.
RESULTS: The global transcutaneous bilirubin nomogram included >119,000 readings from 44,392 apparently normal, predominantly breastfed newborns ≥35 weeks gestation. The pooled transcutaneous bilirubin trajectories increased during the first 3 post-natal days, and peaked or plateaued between the 3rd and 4th days.
CONCLUSIONS: We provide the first globally derived transcutaneous bilirubin nomogram that reflects the natural history of early neonatal bilirubinemia in neonates ≥35 weeks gestation.
Kaplan M, Maisels MJ. Natural history of early neonatal bilirubinemia: a global perspective. J Perinatol. 2021 Apr;41(4):873-878. doi: 10.1038/s41372-020-00901-x. Epub 2021 Jan 4. PMID: 33398058.