Improving Post-Discharge Bilirubin Management in Newborns

There is variation and overuse in bilirubin testing among newborns. Multiple repeat testing occurs despite most newborns being at low risk for reaching bilirubin levels that would require phototherapy. Among the Kaiser Permanente birth population, 45 percent have two or more tests and 10 percent four or more tests. While the tests themselves are relatively inexpensive, the burden on families is significant, given the need to bring their newborns into outpatient clinics for repeat testing and the stress of worrying about hyperbilirubinemia. Evidence-based approaches for repeat testing are lacking. The aims of this study are to develop total serum bilirubin nomograms based upon gestational age, develop predictive models for reaching bilirubin levels above the 95th percentile during the first week of life to guide clinicians on the need and timing of post-discharge bilirubin testing, and assess the utility of bilirubin screening at less than 24 hours of age.

0