Effect of publication of the "Practice Parameter for the Management of Hyperbilirubinemia" on treatment of neonatal jaundice

The aim of this study was to evaluate the change in the treatment of neonat al jaundice following introduction of the "American Academy of Pediatrics' Practice Parameter for the management of hyperbiliriubinemia in the healthy term newborn". In a historical control observation cohort study, we examin ed the rate of phototherapy and exchange transfusions among full-term (grea ter than or equal to 37 wk gestation) and near-term (gestational age betwee n 35 and 37 wk and birthweight >2000 g) infants in two community hospitals. The study included all consecutive infants born during two 15-mo study per iods immediately before and after the introduction of the new guidelines, D ata were prospectively recorded in a computerized database. The rate of pho totherapy significantly decreased in the second study period from 7.9% (514 /6499) to 2.9% (251/8650) (p < 0.0001) among full-term infants, and from 20 .9% (102/489) to 9.4% (47/502) (p < 0.0001) in near-term infants. The use o f exchange transfusion was significantly higher (p < 0.001 in the first com pared to the second period: 0.2% (15/6499)) vs 0.03% (3/8650), A significan t decrease was found when the data from each hospital were analyzed separat ely. Conclusion: A significant decrease in the use of phototherapy and exchange transfusion occurred after the publication of the new practice parameters. This trend was observed for both term and preterm newborns, although the ne w guidelines were not intended for infants born before term.