The tendency of BC to underestimate TSB limits its usefulness in neonates with relatively high TSB. In this population, most infants would have required additional evaluation to ensure that TSB was not >10 mg/dL or >15 mg/dL. It seems that the discrepancy between this study and previous studies of BC is related to our relatively large number of TSB values > or =15 mg/dL.

Congenital cytomegalovirus infection was present for 6% of newborns with confirmed hearing impairment, and the majority of those infants were identified on the basis of abnormal newborn hearing screening results.

OBJECTIVES:To evaluate performance of the Minolta JM-103 Jaundice Meter (JM) as a predictor of total serum bilirubin (TSB) in outpatient neonates during the first week postnatal, and to estimate the number of TSB determinations that might be avoided in clinical use. STUDY DESIGN:In neonates evaluated posthospital discharge, JM and TSB results were compared using linear regression and a Bland-Altman plot, and predictive indices were calculated for various JM cutoff values. Utilizing the 2004 American Academy of Pediatrics (AAP) guidelines, the ability of JM to predict risk zone status was determined. RESULTS:Overall correlation between JM and TSB was 0.77 (p<0.001; n ¼ 121). When TSB was >17 mg/dl, a cutoff value for JM of 13 mg/dl had a sensitivity of 1.0, and 50% of TSB determinations would be avoided. CONCLUSIONS:JM may facilitate outpatient management of hyperbilirubinemia by reducing the number of TSB determinations required; however, it does not provide a reliable substitute for laboratory measurement of TSB.

Radiation exposure of prepubertal, adolescent, and pregnant females may increase the risk of a low-birth-weight (LBW) infant weighing less than 2500 g. It is not clear whether radiation has direct effects on the reproductive organs or influences outcomes indirectly through altering thyroid function. Diagnostic dental radiographs deliver low radiation doses to the hypothalamus-pituitary-thyroid axis but not the reproductive structures or fetus. This population-based case-control study examined the effects of dental radiography in women enrolled in a dental insurance plan who had live singleton births in the years 1993-2000. The case group included 1117 women having live singleton births of a LBW infant. Nearly one third of these infants were born at term. The latter infants, born at 37 or more weeks gestation, had birth weights of 1501-2499 g. Each case was matched with 4 control pregnancies resulting in a normal-birth-weight term infant. The age range was 12-45 years.Dental radiography was independent of numerous risk factors for LBW infants. Exposures were more frequent for women having LBW infants than in control women. Of women delivering a LBW infant, 1.9% had received more than 0.4 mGy of radiation, compared with 1.0% of control women. The frequency of exposures exceeding 4 mGy in women delivering a term LBW infant was 3.0%, significantly higher than in the control group. This level of radiation was recorded for 1.6% of women having a preterm LBW infant and 1.0% for those having a VLBW infant (1500 g or less)-not significantly different from the prevalence in women with normal-birth-weight infants. The adjusted odds ratio for a LBW infant in women exposed to more than 4.0 mGy, compared with unexposed women, was 2.27. The figure for women exposed to 0.1-0.4 mGy was 1.20. Considering radiation dose as a continuous variable, an increase of 1 mGy correlated with a 1.83-fold greater chance of a LBW infant. Odds ratios for VLBW and preterm LBW infants were not significantly associated with radiation doses higher than 0.4 mGy. Radiation exposure was, however, strongly associated with birth of a term LBW infant. The odds ratios for VLBW infants and preterm LBW infants were 2.19 and 1.77, respectively. Compared with unexposed women, those exposed to more than 0.4 mGy had an adjusted odds ratio for a term LBW infant was 3.61, and the odds ratio for exposure to 0.1-0.4 mGy was 1.66. More than two thirds of all radiation exposures were delivered in the first trimester of pregnancy.Very low-dose radiation exposure of the maternal head/neck region during pregnancy is associated with an increased risk of having a LBW infant. It cannot be assumed that exposing nonreproductive organs to very-low-dose radiation during pregnancy is safe. EDITORIAL COMMENT(In prepubertal girls, high-dose therapeutic radiation for childhood cancers has been associated with an increased risk of future low-birthweight (LBW) offspring (Chiarelli AM, et al. ABSTRACTPregnancies after successful external cephalic version (ECV) are generally regarded a...