7 Predicting Kernicterus in Severe Unconjugated Hyperbilirubinemia
Bibliographic record
Abstract
Kernicterus, a preventable brain injury due to severe unconjugated hyperbilirubinemia, has re-emerged worldwide. Survivors have hearing, speech and movement disorders as a long term outcome. Assessments after exchange transfusion may identify newborns that need early intervention, family support and appropriate follow-up. To identify prognostic predictors of kernicterus in the newborn with severe unconjugated hyperbilirubinemia. Retrospective cohort study with follow-up to a mean age of 17 months (range 6–36 months) of newborns >35 weeks gestation at birth, admitted between 1999-March 2003 to a regional tertiary care center for severe unconjugated hyperbilirubinemia (bilirubin >75%tile for age in hours). Abstracted data included clinical presentation, peak unconjugated bilirubin levels, neuroimaging findings, medical/interventional management, and long term follow-up. Predictors of kernicterus were identified by univariate and multivariate analyses. 29 newborns were admitted with severe unconjugated hyper-bilirubinemia. Peak bilirubin level ranged from 286 μmol/L at 6 hours to 780 μmol/L at 120 hours of age. All infants required an exchange transfusion. Auditory evoked responses (AER) were obtained on all newborns and 11/29 had neuroimaging in the acute phase. One died and 7 (27%) had findings suggestive of kernicterus (abnormalities of tone, hearing loss and developmental delay) at follow-up. Birth weight, gestational age, peak MBR, age at presentation, and age at intervention were not predictive of kernicterus. Auditory evoked responses at 5–8 months of age were highly predictive of the later development of kernicterus. The usefulness of neuroimaging in the acute phase remains unclear. Hearing assessments should always be included in the follow up of newborns with severe unconjugated hyperbilirubinemia. refers to presence of one of the following at discharge: hypertonia, retrocollis, opisthotonus AER performed prior to discharge AER follow-up performed at 5–8 months of age
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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 | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| 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".