Hyperbilirubinemia has been a concern to Neonatologists and Pediatricians alike. In the United States women who have had a normal spontaeous delivery will be discharged with their newborn 36 to 48 hours after birth. Usually the jaundice doesn't become obvious to the parents until day four of baby's life and an inexperienced mother might even miss the first symptoms of hyperbilirubinemia. The vicious cycle of a sleepy jaundiced child who doesn't wake up for its feeds and therefore gets even more jaundiced due to lack of fluid intake takes its course. It would be very beneficial to know whether a newborn will get jaundiced to the degree that it requires phototherapy before the baby gets discharged from the hospital. This would spare the parents a lot of distress (readmission of child for phototherapy), give the pediatrician another tool to decide when to bring the baby back for follow-up and would save our health system a lot of money. The breath analyzer used in this study takes advantage of the carbon monoxide production in the infant's breath at 24 to 36 hours of life. As the CO in the endtidal breath (ETCO) is realted to the child's hemoglobin breakdown, it can estimate the subsequent bilirubin production. The baby's exhaled air is analyzed by a CO-Stat End Tidal Breath Analyzer and requires passive breathing for only 1 1/2 minutes. A special sampler is placed at the nostril of the baby to analyze the breath. To make sure that the child wasn't jaundiced at the time of the test (remember it is supposed to predict hyperbilirubinemia and not state the child's jaundice) a serum total bilirubin is measured at 24 to 36 hours postdelivery with the newborn screening test. At 96 hours (4th day of life) another bilirubin is drawn to relate the ETCO result to the child's jaundice. If the results fall below the 45th percentile or above the 95th of a standard hour bilirubin nomogram, the child exits the study. Otherwise the baby is monitored over the next 24 to 48 hours regarding its jaundice and if needed, placed under phototherapy. The ETCO result will ultimately identify neonates who are at high risk of developing hyperbilirubinemia and make painful blood sampling for a serum total bilirubin obsolete in the future. The goal is to establish a routine newborn screening test applied to all well babies in the nursery before discharge.

National Institute of Health (NIH)
National Center for Research Resources (NCRR)
General Clinical Research Centers Program (M01)
Project #
Application #
Study Section
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Stanford University
United States
Zip Code
Evangelou, Evangelos (see original citation for additional authors) (2018) Genetic analysis of over 1 million people identifies 535 new loci associated with blood pressure traits. Nat Genet 50:1412-1425
Doherty, Aiden; Smith-Byrne, Karl; Ferreira, Teresa et al. (2018) GWAS identifies 14 loci for device-measured physical activity and sleep duration. Nat Commun 9:5257
Askie, Lisa M; Darlow, Brian A; Finer, Neil et al. (2018) Association Between Oxygen Saturation Targeting and Death or Disability in Extremely Preterm Infants in the Neonatal Oxygenation Prospective Meta-analysis Collaboration. JAMA 319:2190-2201
Frayling, Timothy M; Beaumont, Robin N; Jones, Samuel E et al. (2018) A Common Allele in FGF21 Associated with Sugar Intake Is Associated with Body Shape, Lower Total Body-Fat Percentage, and Higher Blood Pressure. Cell Rep 23:327-336
Latva-Rasku, Aino; Honka, Miikka-Juhani; Stan?áková, Alena et al. (2018) A Partial Loss-of-Function Variant in AKT2 Is Associated With Reduced Insulin-Mediated Glucose Uptake in Multiple Insulin-Sensitive Tissues: A Genotype-Based Callback Positron Emission Tomography Study. Diabetes 67:334-342
Srinivasan, Lakshmi; Page, Grier; Kirpalani, Haresh et al. (2017) Genome-wide association study of sepsis in extremely premature infants. Arch Dis Child Fetal Neonatal Ed 102:F439-F445
Di Fiore, Juliann M; Martin, Richard J; Li, Hong et al. (2017) Patterns of Oxygenation, Mortality, and Growth Status in the Surfactant Positive Pressure and Oxygen Trial Cohort. J Pediatr 186:49-56.e1
Denson, Lee A; McDonald, Scott A; Das, Abhik et al. (2017) Early Elevation in Interleukin-6 is Associated with Reduced Growth in Extremely Low Birth Weight Infants. Am J Perinatol 34:240-247
Holmes, Michael V; Pulit, Sara L; Lindgren, Cecilia M (2017) Genetic and epigenetic studies of adiposity and cardiometabolic disease. Genome Med 9:82
Younge, Noelle; Goldstein, Ricki F; Bann, Carla M et al. (2017) Survival and Neurodevelopmental Outcomes among Periviable Infants. N Engl J Med 376:617-628

Showing the most recent 10 out of 589 publications