The value of routine bilirubin screening to detect significant hyperbilirubinemia in Thai healthy term newborns

Abstract

Objective: 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.

Material and method: 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.

Results: 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.

Conclusion: 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.