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Universal screening lowers risk of severe jaundice in infants
Date:9/27/2009

The study evaluated the impact of implementation of the 2004 American Academy of Pediatrics (AAP) guideline on the management of jaundice in the Northern California facilities operated by Kaiser Permanente. The guideline recommends that every newborn be assessed for the risk of developing severe jaundice with a bilirubin level before discharge home and/or an assessment of clinical risk factors.

With universal screening, researchers noted a 62 percent decrease in the number of newborns with very high bilirubin levels. The study also describes an increase in the use of phototherapy to treat infants with elevated bilirubin levels, sometimes even when the AAP guidelines did not call for it.

Researchers in this study evaluated both blood tests and devices that estimate the bilirubin level from the color of the baby's skin as methods of screening. "The method didn't seem to matter as much as changing the standard operating procedure, such that all babies are screened," said study co-author Gabriel Escobar, MD, regional director for hospital operations research and a research scientist with the Kaiser Permanente Division of Research's Perinatal Research Unit in Oakland, CA. "With additional education to help avoid excessive use of phototherapy, we think universal screening is a very good tool to reduce cases of serious hyperbilirubinemia."

"This research highlights the power of laboratory databases in supporting research and quality improvement," according to senior author Thomas B. Newman, MD, MPH, with the UCSF Department of Epidemiology and Biostatistics and the UCSF Division of General Pediatrics.


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Contact: Kate Schoen
kschoen@pubaff.ucsf.edu
415-476-2557
University of California - San Francisco
Source:Eurekalert

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