Extreme Hyperbilirubinemia and Rescue Exchange Transfusion in California from 2007 to 2012

Overview

Journal J Perinatol

Specialty Gynecology & Obstetrics

Date 2016 Jul 22

PMID 27442156

Citations 11

Authors

V K Bhutani

N F Meng

Y Knauer

B H Danielsen

R J Wong

D K Stevenson

J B Gould

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate the impact of statewide learning collaboratives that used national guidelines to manage jaundice on the serial prevalence of extreme hyperbilirubinemia (EHB, total bilirubin ⩾25 mg dl(-1)) and exchange transfusions introduced in California Perinatal Quality Care Collaborative (CPQCC) hospitals in 2007.

Study Design: Adverse outcomes were retrieved from statewide databases on re-admissions for live births ⩾35 weeks' gestation (2007 to 2012) in diverse CPQCC hospitals. Individual and cumulative select perinatal risk factors and frequencies were the outcomes measures.

Results: For 3 172 762 babies (2007 to 2012), 92.5% were ⩾35 weeks' gestation. Statewide EHB and exchange rates decreased from 28.2 to 15.3 and 3.6 to 1.9 per 100 000 live births, respectively. From 2007 to 2012, the trends for TB>25 mg dl(-1) rates were -0.92 per 100 000 live births per year (95% CI: -3.71 to 1.87, P=0.41 and R(2)=0.17).

Conclusion: National guidelines complemented by statewide learning collaboratives can decrease or modify outcomes among all birth facilities and impact clinical practice behavior.

Citing Articles

Efficacy of single-and double-volume exchange transfusion for neonatal hyperbilirubinemia.

Xiong Z, Liu X, Li X J Med Biochem. 2023; 42(3):484-491.

PMID: 37790206 PMC: 10543125. DOI: 10.5937/jomb0-42668.

Assessment, management, and incidence of neonatal jaundice in healthy neonates cared for in primary care: a prospective cohort study.

van der Geest B, de Mol M, Barendse I, de Graaf J, Bertens L, Poley M Sci Rep. 2022; 12(1):14385.

PMID: 35999237 PMC: 9399078. DOI: 10.1038/s41598-022-17933-2.

Effect of acupressure combined with Yinzhihuang granules on neonatal jaundice: a systematic review and meta-analysis of randomized controlled trials.

Wu F, Huang C, Lin M, Wang L, Xu K, Zhou X Transl Pediatr. 2022; 11(2):219-228.

PMID: 35282023 PMC: 8905108. DOI: 10.21037/tp-22-22.

Exchange Transfusion in Neonatal Sepsis: A Narrative Literature Review of Pros and Cons.

Iijima S J Clin Med. 2022; 11(5).

PMID: 35268331 PMC: 8910835. DOI: 10.3390/jcm11051240.

Extreme neonatal hyperbilirubinemia and kernicterus spectrum disorder in Denmark during the years 2000-2015.

Donneborg M, Hansen B, Vandborg P, Rodrigo-Domingo M, Ebbesen F J Perinatol. 2020; 40(2):194-202.

PMID: 31907395 DOI: 10.1038/s41372-019-0566-8.

References

Geiger A, Petitti D, Yao J . Rehospitalisation for neonatal jaundice: risk factors and outcomes. Paediatr Perinat Epidemiol. 2001; 15(4):352-8. DOI: 10.1046/j.1365-3016.2001.00374.x. View

Brooks J, Fisher-Owens S, Wu Y, Strauss D, Newman T . Evidence suggests there was not a "resurgence" of kernicterus in the 1990s. Pediatrics. 2011; 127(4):672-9. DOI: 10.1542/peds.2010-2476. View

Maisels M, Kring E . Length of stay, jaundice, and hospital readmission. Pediatrics. 1998; 101(6):995-8. DOI: 10.1542/peds.101.6.995. View

Kaplan M, Hammerman C . The need for neonatal glucose-6-phosphate dehydrogenase screening: a global perspective. J Perinatol. 2009; 29 Suppl 1:S46-52. DOI: 10.1038/jp.2008.216. View

Mah M, Clark S, Akhigbe E, Englebright J, Frye D, Meyers J . Reduction of severe hyperbilirubinemia after institution of predischarge bilirubin screening. Pediatrics. 2010; 125(5):e1143-8. DOI: 10.1542/peds.2009-1412. View

Brown A, Kim M, Wu P, Bryla D . Efficacy of phototherapy in prevention and management of neonatal hyperbilirubinemia. Pediatrics. 1985; 75(2 Pt 2):393-400. View

Bhutani V, Johnson L, Jeffrey Maisels M, Newman T, Phibbs C, Stark A . Kernicterus: epidemiological strategies for its prevention through systems-based approaches. J Perinatol. 2004; 24(10):650-62. DOI: 10.1038/sj.jp.7211152. View

Newman T, Xiong B, Gonzales V, Escobar G . Prediction and prevention of extreme neonatal hyperbilirubinemia in a mature health maintenance organization. Arch Pediatr Adolesc Med. 2000; 154(11):1140-7. DOI: 10.1001/archpedi.154.11.1140. View

Vandborg P, Hansen B, Greisen G, Jepsen M, Ebbesen F . Follow-up of neonates with total serum bilirubin levels ≥ 25 mg/dL: a Danish population-based study. Pediatrics. 2012; 130(1):61-6. DOI: 10.1542/peds.2011-2760. View

10.

Keren R, Luan X, Friedman S, Saddlemire S, Cnaan A, Bhutani V . A comparison of alternative risk-assessment strategies for predicting significant neonatal hyperbilirubinemia in term and near-term infants. Pediatrics. 2008; 121(1):e170-9. DOI: 10.1542/peds.2006-3499. View

11.

Bhutani V, Johnson L . Synopsis report from the pilot USA Kernicterus Registry. J Perinatol. 2009; 29 Suppl 1:S4-7. DOI: 10.1038/jp.2008.210. View

12.

Norman M, Aberg K, Holmsten K, Weibel V, Ekeus C . Predicting Nonhemolytic Neonatal Hyperbilirubinemia. Pediatrics. 2015; 136(6):1087-94. DOI: 10.1542/peds.2015-2001. View

13.

Stark A . Levels of neonatal care. Pediatrics. 2004; 114(5):1341-7. DOI: 10.1542/peds.2004-1697. View

14.

Jeffrey Maisels M, Bhutani V, Bogen D, Newman T, Stark A, Watchko J . Hyperbilirubinemia in the newborn infant > or =35 weeks' gestation: an update with clarifications. Pediatrics. 2009; 124(4):1193-8. DOI: 10.1542/peds.2009-0329. View

15.

Newman T, Liljestrand P, Escobar G . Combining clinical risk factors with serum bilirubin levels to predict hyperbilirubinemia in newborns. Arch Pediatr Adolesc Med. 2005; 159(2):113-9. DOI: 10.1001/archpedi.159.2.113. View

16.

Eggert L, Wiedmeier S, Wilson J, Christensen R . The effect of instituting a prehospital-discharge newborn bilirubin screening program in an 18-hospital health system. Pediatrics. 2006; 117(5):e855-62. DOI: 10.1542/peds.2005-1338. View

17.

Sgro M, Campbell D, Shah V . Incidence and causes of severe neonatal hyperbilirubinemia in Canada. CMAJ. 2006; 175(6):587-90. PMC: 1559442. DOI: 10.1503/cmaj.060328. View

18.

Usatin D, Liljestrand P, Kuzniewicz M, Escobar G, Newman T . Effect of neonatal jaundice and phototherapy on the frequency of first-year outpatient visits. Pediatrics. 2010; 125(4):729-34. PMC: 3197860. DOI: 10.1542/peds.2009-0172. View

19.

. Screening of infants for hyperbilirubinemia to prevent chronic bilirubin encephalopathy: US Preventive Services Task Force recommendation statement. Pediatrics. 2009; 124(4):1172-7. DOI: 10.1542/peds.2009-0128. View

20.

. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2004; 114(1):297-316. DOI: 10.1542/peds.114.1.297. View