{
  "abstract": "Total serum bilirubin (TSB) is measured routinely in neonates, but whether its trajectory over the first postnatal week adds prognostic value beyond a single measurement is unclear. In this preregistered two-database retrospective cohort study, we fitted latent-class trajectory models separately within each database (primary analysis) and on the pooled population (secondary analysis), including neonates admitted at < 28 days of age with at least three TSB measurements on postnatal days 0–7 (MIMIC-III, n = 2,951; PIC, n = 1,817). Site-specific models identified four classes in MIMIC-III and two in PIC; agreement with pooled classes was low (adjusted Rand index 0.23 and 0.25). High-risk classes were associated with the composite outcome of in-hospital death, necrotizing enterocolitis, or late-onset sepsis in both databases (MIMIC-III: OR 5.66 [95% CI 3.72–8.61] and 3.16 [2.10–4.77]; PIC: OR 2.13 [1.40–3.24]). Outcome drivers differed: MIMIC-III associations reflected necrotizing enterocolitis and late-onset sepsis, whereas the PIC association reflected death. In MIMIC-III, birth-weight adjustment substantially attenuated the associations (Class 4 3.05→1.16; Class 1 5.47→1.85), whereas in PIC, where birth weight was unavailable, admission-weight adjustment strengthened the Class 1 association (OR 2.45→3.81). The trajectory model did not exceed the peak TSB value in MIMIC-III (AUC 0.825 vs. 0.827) and performed poorly in PIC (AUC 0.582; corrected calibration slope 0.719), indicating failed external validation. The hour-specific Bhutani nomogram comparison was applied outside its validated ≥ 35-week population. Bilirubin trajectories largely mark underlying immaturity and illness severity rather than a bilirubin-specific effect; these hypothesis-generating findings require prospective validation, particularly in infants born at ≥ 35 weeks.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "name": "Jingchuan Lu"
    },
    {
      "name": "Meiding Wang"
    },
    {
      "name": "Haiyi Xu"
    },
    {
      "name": "Shuangyan Zhu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3hrkf3fnhq4y1.bib",
  "cited_by": 0,
  "doi": "10.1038/s41598-026-76725-0",
  "fulltext_url": null,
  "id": "3hrkf3fnhq4y1",
  "issns": [
    "2045-2322"
  ],
  "landing_url": "https://www.nature.com/articles/s41598-026-76725-0",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2735|Neonatal Health and Biochemistry"
    ]
  ],
  "openalex": "W7220672453",
  "pdf_url": "https://www.nature.com/articles/s41598-026-76725-0_reference.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-25",
  "publisher": "Springer Science and Business Media LLC",
  "ris": "https://research.draconitic.com/paper/3hrkf3fnhq4y1.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:34Z",
      "native_id": "10.1038/s41598-026-76725-0",
      "source": "crossref",
      "url": "https://www.nature.com/articles/s41598-026-76725-0"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2735|Neonatal Health and Biochemistry",
      "subfield": "reproductive-child"
    }
  ],
  "title": "Neonatal bilirubin trajectory phenotypes and composite adverse outcomes: a two-database latent-class analysis (MIMIC-III and PIC)",
  "title_text": "Neonatal bilirubin trajectory phenotypes and composite adverse outcomes: a two-database latent-class analysis (MIMIC-III and PIC)",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:34Z",
  "url": "https://research.draconitic.com/paper/3hrkf3fnhq4y1",
  "venue": "Scientific Reports",
  "versions": []
}