Background: The Bilicare™ is a new device that measures transcutaneous bilirubin (TcB) level at the ear pinna. There are only few studies which have evaluated its accuracy in clinical practice.Objective: This study aims to determine the accuracy of Bilicare™ as a predischarge screening tool in late preterm and term neonates and to define the optimal cutoff point for determining the need to measure total serum bilirubin (TSB).Methods: The 35 weeks' gestation or more and healthy neonates who underwent predischarge TSB measurement were enrolled. Bilicare™ TcB was measured within 30 minutes of blood sampling. Paired TcB and TSB data were analyzed.Results: We collected 214 paired samples. Mean age (SD) at TcB measurement was 57.17 (7.47) hours. Mean TSB (SD) was 9.79 (2.83) mg/dL. TcB showed a significant correlation with TSB (r = 0.84, r2 = 0.7). The mean difference (SD) between TcB and TSB was 0.7 (0.21) mg/dL (95%CI 0.49-0.91). TcB tended to overestimate TSB level at the TSB values of <12 mg/dL but underestimate at the higher TSB level. The accuracy of using TcB values to detect neonates who required phototherapy was 92.5%. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 78.3, 94.2, 62.1, and 97.3%, respectively. If TcB +3 mg/dL was applied as a cutoff point, the sensitivity, specificity, PPV, and NPV were 100, 53.9, 20.7, and 100%, respectively.Conclusions: Bilicare™ TcB and TSB measurements were well correlated. The TcB level +3 mg/dL could detect all neonates who had significant hyperbilirubinemia requiring phototherapy during their birth hospitalization.

Background and Aims: Preterm newborns are particularly susceptible to hypovitaminosis D, potentially impairing bone mineralization. In Thailand, data on its prevalence and standardized supplementation protocols remain limited. This study aimed to compare the efficacy of two vitamin D3 dosages (400 IU/day vs. 800 IU/day) in improving serum vitamin D concentrations and metabolic bone parameters in preterm newborns. Methods: A randomized controlled trial was conducted in preterm newborns born at ≤32 weeks’ gestation or with birth weight ≤1500 g. Preterm newborns were randomized to receive either 400 IU or 800 IU/day of vitamin D3. Serum 25-hydroxyvitamin D (25(OH)D) was measured using electrochemiluminescence immunoassay (ECLIA). Metabolic bone parameters—including calcium, phosphorus, alkaline phosphatase, and albumin—were assessed at baseline and again at six weeks of age. Results: Of the 38 enrolled infants, baseline 25(OH)D levels were comparable between groups (14.8 ± 4.8 ng/mL in the 800 IU/day group vs. 14.7 ± 6.9 ng/mL in the 400 IU/day group). At six weeks, the 800 IU group demonstrated significantly higher 25(OH)D levels (47.3 ± 21.0 ng/mL vs. 32.0 ± 14.2 ng/mL; p = 0.013), with a large effect size (Cohen’s d = 0.85) and the difference-in-differences of +15.7 ng/mL. The prevalence of hypovitaminosis D declined from 89% to 5% in the 800 IU/day group and from 74% to 32% in the 400 IU/day group (p = 0.036). No significant differences in metabolic bone parameters or signs of toxicity were observed. Conclusions: Vitamin D3 supplementation at 800 IU/day significantly improved vitamin D status and reduced hypovitaminosis D in preterm newborns, without observed toxicity.

Objective: To determine the incidence, causative pathogens, risk factors, and clinical outcomes of early-onset sepsis (EOS) in very preterm (gestational age < 32 weeks) and very low birth weight (birth weight < 1500 g) neonates. Methods: This retrospective study analyzed data from the Thai Neonatal Network registry (2019–2024; total 22 neonatal units). EOS was defined as bacteremia or bacterial meningitis within 72 h of birth. Results: Among 792 neonates (median [interquartile range] gestational age, 28 [26–29] weeks; median [interquartile range] birth weight, 960 [779–1190] g), the incidence of EOS was 4.0% (n = 32). Predominant pathogens were Escherichia coli (n = 10) and Acinetobacter baumannii (n = 9). Antibiograms showed high non-susceptibility for E. coli and A. baumannii to gentamicin (44.4% and 83.3%, respectively) and cefotaxime (37.5% and 75.0%, respectively). Although E. coli remained susceptible to amikacin and meropenem (100%), A. baumannii exhibited extensive resistance (66.7% and 83.3%, respectively). Multivariable analysis identified chorioamnionitis (adjusted odds ratio [aOR] 1.12; 95% confidence interval [CI]: 1.07–1.18) and 5 min Apgar score < 7 (aOR 1.05; 95% CI: 1.02–1.18) as significant risk factors. EOS was independently associated with increased early neonatal mortality within 7 days of life (aOR, 1.26; 95% CI: 1.16–1.36). Conclusions: The incidence of EOS is high among very preterm infants in Thailand and significantly increases mortality rates. The prevalence of multidrug-resistant A. baumannii in neonatal EOS is a critical concern that limits the efficacy of empirical treatments. These findings highlight the urgent need for targeted interventions and enhanced antimicrobial stewardship to improve neonatal survival rates.