Table 5.1Negative predictive value (NPV) of low degree of jaundice assessed by visual inspection

Study detailsSample characteristicsTiming of assessmentIndicator of absent jaundice or low-grade jaundiceDefinition of severe hyperbilirubinaemiaResults
Riskin et al. (2008)61Healthy full-term and late preterm babies with GA≥ 35 weeks before discharge (n = 1129)Mean: 62 ± 24 hours (median 55 hours; range 9–252 hours)Clinical icterus assessed to be in zone A/low-risk zone on Bhutani's nomogram (< 40th centile)Serum bilirubin levels in zone B, C and D or in intermediate (low, high) and high-risk zones on Bhutani's nomogram (> 40th centile)NPV: 91.9% (2627/2857) Negative LR: 0.45
Moyer et al. (2000)60Full-term healthy babies with BW > 2000 g and GA > 36 weeks (n = 122)Mean age 2 days (range 8 hours to 7 days)Presence of icterus in lower chest (nipple line to umbilicus)Serum bilirubin levels > 205 micromol/litreNPV: 94.3% (33/35)
Negative LR: 0.15
Szabo et al. (2004)56Healthy full-term babies with BW > 2000 g and no older than 6 days (n = 140)
Excluded: jaundice within 36 hours
Data not givenKramer zone 2 assessed by nurses (data not given for zone 0 or 1)Serum bilirubin levels > 250 micromol/litreNPV: 100%

BW = birthweight; GA = gestational age; LR = likelihood ratio; NPV = negative predictive value

From: 5, Recognition

Cover of Neonatal Jaundice
Neonatal Jaundice.
NICE Clinical Guidelines, No. 98.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2010 May.
Copyright © 2010, Royal College of Obstetricians and Gynaecologists.

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