ArticleJournal of perinatology : official journal of the California Perinatal Association2026
Bilirubin kinetics in preterm infants.
Article in Journal of perinatology : official journal of the California Perinatal Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPreterm infants are vulnerable to bilirubin neurotoxicity. We evaluated whether time-stratified transcutaneous bilirubin (TcB) and kinetic indices improve the prediction of the risk of phototherapy and escalation.
methodsIn a cohort of preterm infants, only pre-phototherapy TcB values were analyzed. TcB values were grouped by postnatal age (≤24 h, 25-48 h, 49-72 h, ≥73 h), and sequential measurements were used to calculate bilirubin increase rates (RBIa, RBIb) and absolute percent change (APC%).
resultsInfants requiring phototherapy had higher TcB levels within 72 h, particularly at ≤24 h and 25-48 h. Independent predictors included TcB (OR 2.11), gestational age (OR 0.37), and postnatal age (OR 0.30; AUC 0.827). Treated infants showed faster bilirubin accumulation, and early RBIa correlated with peak TcB (r = 0.334). APC% independently predicted proximity to the escalation threshold.
conclusionsTime-standardized TcB measurements and dynamic kinetic indices may facilitate earlier identification of preterm infants at increased risk for phototherapy and warrant prospective validation.
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