167: Comparing Rate of Severe Neonatal Hyperbilirubinemia in Three Western Industrialized Populations: Canada, the United Kingdom & Ireland, and Switzerland
Bibliographic record
Abstract
Severe neonatal hyperbilirubinemia is very rare and can be associated with significant morbidity, including bilirubin encephalopathy and death. Despite the implementation of routine screening guidelines and access to readily available treatment, severe neonatal hyperbilirubinemia continues to be reported in western industrialized countries. Our primary objective is to describe and compare the incidence of severe neonatal hyperbilirubinemia in three western, industrialized nations (Canada, the United Kingdom and Ireland, and Switzerland). Our secondary objective is to identify and describe demographic and clinical variables associated with severe neonatal hyperbilirubinemia. Using data derived from three national surveillance programs, the Canadian Paediatric Surveillance Program (CPSP) (2002–2004), the British Pediatric Surveillance Unit (BPSU) (2003–2005), and the Swiss Pediatric Surveillance Unit (SPSU) (2007–2008), we compared the incidence of severe neonatal hyperbilirubinemia among the three populations. Descriptive statistics were used to compare demographic and clinically relevant variables as well as treatment practices and indicators of early neurological sequelae. Preliminary comparisons between the CPSP and BPSU data were performed. Chi-square test for differences in proportions was performed on categorical data and CIs were calculated for means with standard deviations. Statistical significance was assumed if CIs did not overlap. Preliminary analysis has estimated the incidence of severe neonatal hyperbilirubinemia to be 40 per 100,000 live births in Canada, seven per 100,000 live births in the United Kingdom and Ireland, and 41 per 100,000 live births in Switzerland. The Canadian and British groups reported mean peak serum bilirubin levels to be 471 μmol/L (156 μmol/L to 841 μmol/L) and 580 μmol/L (510 μmol/L to 802 μmol/L) respectively, and the incidence of bilirubin encephalopathy to be five per 100,000 live births and 0.9 per 100,000 live births respectively. Canadian patients were more likely to have vaginal births (78.7% vs. 58.3%); P=0.02. United Kingdom patients were more likely to be delivered by C-section (18.5% vs. 4.3%); P=0.02. There were no statistically significant difference in gender, mean gestational age, mean birth weight, feeding method, and mean age at presentation Despite the implementation of screening guidelines to identify infants with high serum bilirubin levels, severe neonatal hyperbili-rubinemia continues to occur in western, industrialized populations
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".