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Objective <p>To evaluate the impact of routine 6-h transcutaneous bilirubin (TcB) surveillance on bilirubin rate-of-rise (ROR) values meeting American Academy of Pediatrics (AAP) age-specific cut-points.</p> Study design <p>Retrospective cohort study of healthy newborns ( ≥ 35 weeks’ gestation, ≥2.0 kg) undergoing routine 6-h TcB monitoring during birth hospitalization. ROR was calculated from consecutive TcB pairs and assessed as a screening test for selected hemolytic hyperbilirubinemia neurotoxicity risk factors (HNRFs).</p> Results <p>Among 621 newborns (3787 TcB measurements), 71.8% had ≥1 AAP ROR cut-point. Nearly one-quarter of these events were preceded by a negative slope, indicating frequently variable TcB trajectories. Extending surveillance from 6 to 12 h reduced the odds of AAP ROR cut-points by ~60%. As a screening test for HNRFs, AAP ROR cut-points demonstrated moderate sensitivity (73%) but low specificity (28%).</p> Conclusions <p>Routine 6-h TcB surveillance yields frequent AAP ROR cut-points with poor HNRF specificity, limiting short-interval ROR clinical utility.</p>

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Bilirubin rate of rise during routine 6-h transcutaneous bilirubin surveillance

  • 期刊论文

  • 发表日期：

    2026年4月27日

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  • Sameer Yaseen Al-Abdi

摘要

Objective

To evaluate the impact of routine 6-h transcutaneous bilirubin (TcB) surveillance on bilirubin rate-of-rise (ROR) values meeting American Academy of Pediatrics (AAP) age-specific cut-points.

Study design

Retrospective cohort study of healthy newborns ( ≥ 35 weeks’ gestation, ≥2.0 kg) undergoing routine 6-h TcB monitoring during birth hospitalization. ROR was calculated from consecutive TcB pairs and assessed as a screening test for selected hemolytic hyperbilirubinemia neurotoxicity risk factors (HNRFs).

Results

Among 621 newborns (3787 TcB measurements), 71.8% had ≥1 AAP ROR cut-point. Nearly one-quarter of these events were preceded by a negative slope, indicating frequently variable TcB trajectories. Extending surveillance from 6 to 12 h reduced the odds of AAP ROR cut-points by ~60%. As a screening test for HNRFs, AAP ROR cut-points demonstrated moderate sensitivity (73%) but low specificity (28%).

Conclusions

Routine 6-h TcB surveillance yields frequent AAP ROR cut-points with poor HNRF specificity, limiting short-interval ROR clinical utility.