Abstract
Background and Objectives: This work aimed to develop a predictive model of neonatal acute bilirubin encephalopathy.Methods: We retrospectively analyzed the data on extreme hyperbilirubinemia (EHB) newborns hospitalized in the First Hospital of Jilin University from January 1, 2012 to December 31, 2019. The demographic characteristics, pathological information, and admission examination results of newborns were collected to analyze the factors affecting acute bilirubin encephalopathy and to establish a predictive model.Results: A total of 517 newborns were included in this study, of which 102 (19.7%) had acute bilirubin encephalopathy. T1WI hyperintensity [18.819 (8.838–40.069)], mother's age > 35 years [2.618 (1.096–6.2530)], abnormal white blood cell (WBC) [6.503 (0.226–18.994)], TSB level [1.340 (1.242–1.445)], and albumin level [0.812 (0.726–0.907)] were independently associated with neonatal acute bilirubin encephalopathy (ABE). All independently associated risk factors were used to form an ABE risk estimation nomogram. The bootstrap validation method was used to internally validate the resulting model. The nomogram demonstrated good accuracy in predicting the risk of ABE, with an unadjusted C index of 0.943 (95% CI, 0.919–0.962) and a bootstrap-corrected C index of 0.900.Conclusion: A nomogram was constructed using five risk factors of ABE. This model can help clinicians determine the best treatment for neonatal hyperbilirubinemia.
Highlights
Hyperbilirubinemia is a common disease in newborns, occurring in more than 84% of late preterm and term neonates [1]
A total of 517 newborns were included in this study, of which 102 (19.7%) had acute bilirubin encephalopathy
The nomogram demonstrated good accuracy in predicting the risk of acute bilirubin encephalopathy (ABE), with an unadjusted concordance index (C index) of 0.943 and a bootstrap-corrected C index of 0.900
Summary
Hyperbilirubinemia is a common disease in newborns, occurring in more than 84% of late preterm and term neonates [1]. The incidence of ABE may have decreased in developed countries in recent years, but it still occurs at a rate of 0.4 to 2.7 cases per 100,000 infants [3, 4], with a higher incidence in Asia, the Middle East, and Africa [5]. In theory, this is an entirely avoidable problem if we can predict and intervene early. An expert panel recommended the use of TSB or transcutaneous bilirubin in combination with clinical risk factors as an indicator for discharge evaluation in neonates with hyperbilirubinemia [8]. This work aimed to develop a predictive model of neonatal acute bilirubin encephalopathy
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