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. 2022 Sep 6:10:947066.
doi: 10.3389/fped.2022.947066. eCollection 2022.

Transcutaneous bilirubin-based screening reduces the need for blood exchange transfusion in Myanmar newborns: A single-center, retrospective study

Hiromi Suzuki  1 , Saneyuki Yasuda  2 , Yinmon Htun  3 , Nant San San Aye  4 , Hnin Oo  4 , Thet Paing Oo  5 , Zaw Lin Htut  4 , Kosuke Koyano  3 , Shinji Nakamura  3 , Takashi Kusaka  3
Affiliations

Transcutaneous bilirubin-based screening reduces the need for blood exchange transfusion in Myanmar newborns: A single-center, retrospective study

Hiromi Suzuki et al. Front Pediatr. .

Abstract

Background: Neonatal hyperbilirubinemia is a significant health problem in Myanmar. We introduced transcutaneous bilirubin (TcB) measurements in 2017 and developed an hour-specific TcB nomogram for early detection and treatment of hyperbilirubinemia in Myanmar neonates. This study aimed to evaluate whether our screening method for hyperbilirubinemia decreased the requirement of blood exchange therapy (ET).

Methods: This retrospective cohort study was conducted at the Central Women's Hospital, Yangon. Two groups were included as follows: group 1 (control group; comprising infants born in 2016 and screened on the basis of Kramer's rule), and group 2 (intervention group; comprising infants born in 2019 and screened by TcB measurement using a nomogram). The number of ETs was analyzed based on causes of hyperbilirubinemia and number of days after birth.

Results: Groups 1 and 2 comprised 12,968 and 10,090 infants, respectively. Forty-six and two infants in Groups 1 and 2, respectively, required an ET. The odds ratio for ET was 18.0 (Group 1 to Group 2; 95% confidence interval [CI]: 4.8-67.1; p = 0.000). Serum bilirubin values at the time ET was administered were significantly higher in Group 1 than those in Group 2 (median: 23.0 and 16.8, respectively).

Conclusion: The management of hyperbilirubinemia using our screening method (TcB Nomogram) can effectively reduce the need for ET in neonates in Myanmar.

Keywords: blood exchange therapy; infants; neonatal jaundice; nomogram; phototherapy; transcutaneous bilirubin.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Algorithm of the control and intervention groups for the treatment of hyperbilirubinemia.
FIGURE 2
FIGURE 2
An hour-specific transcutaneous bilirubin nomogram for neonates in Myanmar (gestational age ≥ 35 weeks, birthweight > 2,000 g). This nomogram card was distributed to medical professionals for detecting neonatal hyperbilirubinemia.
FIGURE 3
FIGURE 3
The number of cases that required ET according to the days after birth and causes of hyperbilirubinemia.
See this image and copyright information in PMC

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