THE IMPACT OF PHOTOTHERAPY IN THE MANAGEMENT OF NEONATAL HYPERBILIRUBINEMIA - COMPARISON OF HISTORICAL COHORTS

To quantitatively assess the impact of phototherapy (PT) in the preven tion of kernicterus we calculated the rate of exchange transfusion (ET ) in two large historical cohorts of creek neonates (birthweight great er than or equal to 2.5 kg), one before (period I: 1957-61) and one af ter (period II: 1980-92) the introduction of PT. Overall, the introduc tion of PT was associated with a reduction of the rate of ET from 0.43 % in period I to 0.05% in period II. The reduction was observed in all etiological categories but was more marked in the ABO-incompatible gr oup. With an estimated rate of kernicterus without treatment of 0.085% (excluding rhesus hemolytic disease of the newborn and prematurity) w e estimated that 4.2 and 0.36 infants were treated by ET for each spar ed kernicterus in periods I and II, respectively. Finally, in period I I 185 infants were treated with PT or PT and ET for each spared kernic terus.