Sep 10, 2012 - At present, transcutaneous measurement of biliru- ... poorly with serum bilirubin levels; however, the stu- .... Keren R, Bhutani V, Luan X, et al.
JOURNAL OF TROPICAL PEDIATRICS, VOL. 58, NO. 5, 2012
Editorial
Neonatal Jaundice poorly with serum bilirubin levels; however, the studies do suggest that visual assessment may be useful as a negative predictor. Some studies have looked at clinical risk factors to predict infants who are at risk of developing neonatal jaundice; however, there was considerable variability in criteria used between studies [10–12]. Research is now needed to validate the accuracy and reliability of specific risk factors as predictors, and to evaluate which risk factors are predictive in preterm infants and racially diverse populations. In resource-poor settings, laboratory tests are an expensive commodity; therefore, it is important that their use is justified. In their article, Besser et al. [13] evaluated the efficacy of standard laboratory tests recommended by the American Academy of Paediatrics on neonates undergoing phototherapy in Israel. This retrospective cohort study involved reviewing the charts of 282 neonates with birth weight >2.5 kg who were treated with phototherapy during the first month of their life. All laboratory tests undertaken and their results were documented together with primary and maximum bilirubin values, time to jaundice (in days) and the number of days in follow-up. Laboratory tests conducted included G6PD activity, blood type, direct Coombs’ test, reticulocyte count, total and direct (conjugated) bilirubin and liver function tests. The authors suggest that there is no benefit in conducting a full laboratory investigation to identify the cause of jaundice in neonates undergoing phototherapy when jaundice presents >48 h from birth, unless bilirubin levels are continuing to rise 8 h after starting phototherapy. In babies who present with early jaundice (
