Guidelines for prevention, detection and management of hyperbilirubinaemia in newborns of 35 or more weeks of gestation

Sánchez-Gabriel, María Dolores Sánchez-Redondo; Castellanos, José L; Fernández, Isabel Benavente; Pérez-Muñuzuri, Alejandro; Gracia, Segundo Rite; Campillo, César W. Ruiz; Pons-Fuster, Eduardo; Luna, Manuel Sánchez

doi:10.1016/j.anpede.2017.03.009

Cited by 5 publications

(4 citation statements)

References 34 publications

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“…[6] The qualities of the methodology strategies and recommendations for the treatment of hyperbilirubinemia in the guidelines were analyzed. Although the 12 guidelines indicated the threshold for ET, seven of them (Canadian Pediatric Society, [26] Chinese Pediatric Society, [9] Israel Neonatal Society, [27] Malaysia Health Technology Assessment Section, [28] Queensland Clinical Guidelines, [29] Spanish Association of Pediatrics, [30] and Turkish Pediatric Association [31] ) stated that the ET threshold curve was reproduced from the AAP guidelines. However, the AAP guidelines indicate that the suggested threshold curve for ET is backed by the consensus of a committee and based on limited evidence.…”

Section: Discussionmentioning

confidence: 99%

Intensive phototherapy vs. exchange transfusion for the treatment of neonatal hyperbilirubinemia: a multicenter retrospective cohort study

Zhang

Tang

et al. 2022

Chinese Medical Journal

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Background:Intensive phototherapy (IPT) and exchange transfusion (ET) are the main treatments for extreme hyperbilirubinemia. However, there is no reliable evidence on determining the thresholds for these treatments. This multicenter study compared the effectiveness and complications of IPT and ET in the treatment of extreme hyperbilirubinemia.Methods:This retrospective cohort study was conducted in seven centers from January 2015 to January 2018. Patients with extreme hyperbilirubinemia that met the criteria of ET were included. Patients were divided into three subgroups (low-, medium-, and high- risk) according to gestational week and risk factors. Propensity score matching (PSM) was performed to balance the data before treatment. Study outcomes included the development of bilirubin encephalopathy, duration of hospitalization, expenses, and complications. Mortality, auditory complications, seizures, enamel dysplasia, ocular motility disorders, athetosis, motor, and language development were evaluated during follow-up at age of 3 years.Results:A total of 1164 patients were included in this study. After PSM, 296 patients in the IPT only group and 296 patients in the IPT plus ET group were further divided into the low-, medium-, and high-risk subgroups with 188, 364, and 40 matched patients, respectively. No significant differences were found between the IPT only and IPT plus ET groups in terms of morbidity, complications, and sequelae. Hospitalization duration and expenses were lower in the low- and medium-risk subgroups in the IPT only group.Conclusions:In this study, our results suggest that IPT is a safe and effective treatment for extreme hyperbilirubinemia. The indication of ET for patients with hyperbilirubinemia could be stricter. However, it is necessary to have a contingency plan for emergency ET as soon as IPT is commenced especially for infants with risk factors. If IPT can be guaranteed and proved to be therapeutic, ET should be avoided as much as possible.

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Section: Discussionmentioning

confidence: 99%

Intensive phototherapy vs. exchange transfusion for the treatment of neonatal hyperbilirubinemia: a multicenter retrospective cohort study

Zhang

Tang

et al. 2022

Chinese Medical Journal

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“…Tables 1 and 2 summarise the general characteristics of the included clinical practice guidelines. Twelve clinical practice guideline documents were published by national or regional organisations, including the American Academy of Pediatrics (AAP) Subcommittee on Hyperbilirubinemia, 13 Canadian Pediatric Society (CPS) Fetus and Newborn Committee, 14 Chinese Pediatric Society (ChPS) Chinese medical Association, 15 Israel Neonatal Society (INS), 16 Italian Society of Neonatology (ISN), 17 Malaysia Health Technology Assessment Section (MaHTAS), 18 NICE in the UK, 19 Norwegian Pediatric Association, 20 Queensland Clinical Guidelines (QCG) in Australia, 21 Spanish Association of Pediatrics (SAP), 22 Swiss Society of Neonatology (SSN) 23 and Turkish Pediatric Association (TPA). 24 Five of these guidelines are new and the others have been updated or reaffirmed.…”

Section: General Characteristics Of the Guidelinesmentioning

confidence: 99%

“…Four guidelines from the USA, 13 Canada, 14 Italy 17 and Switzerland 23 were targeted towards neonates born at >35 weeks of gestation, while the other guidelines covered all preterm and term babies. Six organisations (QCG, 21 CPS, 14 SAP, 22 NICE, 19 INS 16 and MaHTAS 18 reported performing a systematic review and appraisal of the evidence and were explicit about the level of evidence that underpinned their recommendations. Three groups were funded by governmental institutions (QCG, 21 NICE 19 and MaHTAS), 18 one declared no financial support (TPA), 24 and the remainder did not disclose a funding source.…”

Section: General Characteristics Of the Guidelinesmentioning

confidence: 99%

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Systematic review of global clinical practice guidelines for neonatal hyperbilirubinemia

Zhang

Tang

et al. 2021

BMJ Open

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ObjectiveHyperbilirubinemia is one of the most common clinical symptoms in newborns. To improve patient outcomes, evidence-based and implementable guidelines are required. However, clinical guidelines may vary in quality, criteria and recommendations among regions and countries. In this study, we aimed to systematically assess the quality of guidelines using the Appraisal of Guidelines for Research & Evaluation (AGREE)-II instrument and summarise the specific recommendations for neonatal hyperbilirubinemia in order to provide suggestions for future guideline development.DesignSystematic review.InterventionsWe searched the PubMed, Embase, Medline and guideline databases for relevant articles on 10 April 2020. The studies were screened by two independent reviewers according to our inclusion criteria. Two reviewers independently extracted the descriptive data. Four appraisers assessed the guidelines using the AGREE-II instrument.ResultsOur systematic review appraised 12 clinical practice guidelines for the diagnosis and management of neonatal hyperbilirubinemia. The 12 guidelines achieved an average score of 36%–89%. The guidelines received the highest scores for clarity of presentation and lowest scores for rigour of development. Most recommendations for diagnosis were relatively consistent, but recommendations regarding risk factors, the initiating threshold of treatment and pharmacotherapy varied.ConclusionsOur study revealed that current guidelines vary in the quality of the developing process and are inconsistent with regards to recommendations. Future guidelines should afford more attention to the quality of methodologies in guideline development, and more qualified evidence is needed to standardise the initiating threshold of treatment for neonatal hyperbilirubinemia.

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Neonatal jaundice and associated factors in public hospitals of southern Ethiopia: A multi-center cross-sectional study

Bante,

Ahmed,

Degefa

et al. 2024

Heliyon

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Guidelines for prevention, detection and management of hyperbilirubinaemia in newborns of 35 or more weeks of gestation

Cited by 5 publications

References 34 publications

Intensive phototherapy vs. exchange transfusion for the treatment of neonatal hyperbilirubinemia: a multicenter retrospective cohort study

Intensive phototherapy vs. exchange transfusion for the treatment of neonatal hyperbilirubinemia: a multicenter retrospective cohort study

Systematic review of global clinical practice guidelines for neonatal hyperbilirubinemia

Neonatal jaundice and associated factors in public hospitals of southern Ethiopia: A multi-center cross-sectional study

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