Hyperbilirubinemia screening and treatment in neonates born prior to 35 weeks of gestation.
J Neonatal Perinatal Med
; 17(2): 177-182, 2024.
Article
in En
| MEDLINE
| ID: mdl-38427505
ABSTRACT
BACKGROUND:
Guidelines on when to screen for neonatal hyperbilirubinemia apply to infants born at 35 weeks or later of gestation. It is unknown whether infants born earlier would benefit from similar guidelines. Our objective was to examine hyperbilirubinemia screening and phototherapy prescription among early preterm infants during the first 6 days of life.METHODS:
We reviewed the charts of 193 infants born prior to 35 weeks of gestation who were admitted to a tertiary care NICU in Southeastern Ontario in 2018-2019. Information on total serum bilirubin (TSB) measurements over each 12-hour interval during the first six days of life and the treatment decision (no treatment, initiate, continue, or stop phototherapy) was extracted. We also examined what proportion of infants were prescribed phototherapy during each 12-hour interval.RESULTS:
Of 1006 TSB measurements performed over the first 6 days of life, 605 were done to determine whether phototherapy should be initiated. Treatment was prescribed in 275 instances (45%). A higher proportion of infants born prior to 28 weeks of gestation required phototherapy in the first 12 hours of life (37%) compared to those born at 28-32 weeks (20%) and 33-34 weeks (5.7%).CONCLUSIONS:
Our results suggest that TSB measurements are often poorly timed to detect treatment need in infants born prior to 35 weeks of gestation. This unnecessarily increases the risk of complications from phlebotomy and is an ineffective use of health care resources. There is a need to develop guidelines to optimize hyperbilirubinemia screening among early preterm infants.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Phototherapy
/
Infant, Premature
/
Gestational Age
/
Neonatal Screening
/
Hyperbilirubinemia, Neonatal
Country/Region as subject:
America do norte
Language:
En
Journal:
J Neonatal Perinatal Med
Year:
2024
Type:
Article
Affiliation country:
Canada