Universal Predischarge Bilirubin Screening

Howard Bauchner, MD

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In This Article

Abstract and Introduction

Abstract

Implementation of universal screening reduced severe hyperbilirubinemia.

Introduction

Some studies have suggested that universal predischarge bilirubin screening prevents the development of very high bilirubin levels (JW Pediatr Adolesc Med Oct 21 2009 and JW Pediatr Adolesc Med Oct 21 2009). Investigators assessed the effect of mandatory predischarge bilirubin screening at 116 facilities of the Hospital Corporation of America.

Between 2004 and 2008, 129,345 infants were born before implementation of universal screening and 899,472 were born after. Screening involved either serum or transcutaneous hour-specific bilirubin assessment, with follow-up as suggested by the bilirubin nomogram; systemwide adherence was estimated at >98%. Compared with infants born before universal screening, those born after were significantly less like to develop bilirubin levels of 25.0 to 29.9 mg/dL (odds ratio, 0.62) or >30.0 mg/dL (OR, 0.35). The percentage of infants who underwent phototherapy increased significantly from 4.4% in 2004 to 5.1% in 2008. In 2008, 95% of infants who received phototherapy received it during their birth admission only.

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