Prediction of severe neonatal hyperbilirubinemia using cord blood hydrogen peroxide: A prospective study

Hung Chieh Chou, Chiang Ting Chien, Po Nien Tsao, Wu Shiun Hsieh, Chien Yi Chen, Mei Hwei Chang

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: We hypothesized that cord blood hydrogen peroxide (H2O2 ) could be utilized to predict the severity of neonatal hyperbilirubinemia. Methods: We prospectively enrolled term or near-term healthy neonates. Cord blood and capillary blood at three days of age were measured for hydrogen peroxide and bilirubin concentrations. For newborns with hyperbilirubinemia, further blood samples were obtained at five and seven days of age. Newborns were divided into severe or less severe hyperbilirubinemic groups (peak bilirubin ≥17 mg/dL or not). The sensitivity, specificity, and negative predictive values were determined. Results: There were 158 neonates enrolled. The incidence of neonatal hyperbilirubinemia was 30.5% for a concentration ≥15 mg/dl. The rising patterns were similar among bilirubin concentrations and hydrogen peroxide levels during the first few days of life. There was a strong positive correlation between bilirubin concentrations and hydrogen peroxide levels after correlation analysis. The rate of severe hyperbilirubinemia was 13.3%. It revealed that a cord blood hydrogen peroxide signal level of 2500 counts/10 seconds was an appropriate cut-off for predicting severe hyperbilirubinemia. Sensitivity and the negative predictive value were 76.2% and 93.3%, respectively. Conclusions: Our findings confirm that hydrogen peroxide levels and bilirubin concentrations in cord and neonatal blood are closely related. A cord blood hydrogen peroxide level above 2500 counts/10 seconds associated with a high predictive value for severe hyperbilirubinemia. This method provides information about which neonate should be closely followed after discharge from the nursery.

Original languageEnglish
Article numbere86797
JournalPloS one
Volume9
Issue number1
DOIs
Publication statusPublished - 2014 Jan 23

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Neonatal Hyperbilirubinemia
hyperbilirubinemia
prospective studies
Fetal Blood
Hydrogen Peroxide
hydrogen peroxide
Blood
bilirubin
Prospective Studies
Bilirubin
Hyperbilirubinemia
prediction
neonates
blood
blood capillaries
Nurseries
incidence
Sensitivity and Specificity
Incidence

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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Prediction of severe neonatal hyperbilirubinemia using cord blood hydrogen peroxide : A prospective study. / Chou, Hung Chieh; Chien, Chiang Ting; Tsao, Po Nien; Hsieh, Wu Shiun; Chen, Chien Yi; Chang, Mei Hwei.

In: PloS one, Vol. 9, No. 1, e86797, 23.01.2014.

Research output: Contribution to journalArticle

Chou, Hung Chieh ; Chien, Chiang Ting ; Tsao, Po Nien ; Hsieh, Wu Shiun ; Chen, Chien Yi ; Chang, Mei Hwei. / Prediction of severe neonatal hyperbilirubinemia using cord blood hydrogen peroxide : A prospective study. In: PloS one. 2014 ; Vol. 9, No. 1.
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abstract = "Background: We hypothesized that cord blood hydrogen peroxide (H2O2 ) could be utilized to predict the severity of neonatal hyperbilirubinemia. Methods: We prospectively enrolled term or near-term healthy neonates. Cord blood and capillary blood at three days of age were measured for hydrogen peroxide and bilirubin concentrations. For newborns with hyperbilirubinemia, further blood samples were obtained at five and seven days of age. Newborns were divided into severe or less severe hyperbilirubinemic groups (peak bilirubin ≥17 mg/dL or not). The sensitivity, specificity, and negative predictive values were determined. Results: There were 158 neonates enrolled. The incidence of neonatal hyperbilirubinemia was 30.5{\%} for a concentration ≥15 mg/dl. The rising patterns were similar among bilirubin concentrations and hydrogen peroxide levels during the first few days of life. There was a strong positive correlation between bilirubin concentrations and hydrogen peroxide levels after correlation analysis. The rate of severe hyperbilirubinemia was 13.3{\%}. It revealed that a cord blood hydrogen peroxide signal level of 2500 counts/10 seconds was an appropriate cut-off for predicting severe hyperbilirubinemia. Sensitivity and the negative predictive value were 76.2{\%} and 93.3{\%}, respectively. Conclusions: Our findings confirm that hydrogen peroxide levels and bilirubin concentrations in cord and neonatal blood are closely related. A cord blood hydrogen peroxide level above 2500 counts/10 seconds associated with a high predictive value for severe hyperbilirubinemia. This method provides information about which neonate should be closely followed after discharge from the nursery.",
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