In July of 2004, the American Academy of Pediatrics issued revised guidelines to provide a framework for the prevention and management of hyperbilirubinemia in newborn infants of 35 or more weeks of gestation. According to these recommendations, every newborn should be assessed prior to discharge for the risk of developing hyperbilirubinemia. Although the hour-specific nomogram is the best documented method for assessing risk, other identified risk factors for the development of severe hyperbilirubinemia are listed as well.
The AAP guidelines also includes a phototherapy nomogram with recommendations for hour-specific treatment thresholds. On this nomogram, infants are designated as “higher risk” because of the potential negative effects of the conditions listed on albumin binding of bilirubin, the blood-brain barrier, and the susceptibility of the brain cells to damage by bilirubin. For further information please see the references below.
- Bhutani VK, Johnson L, Sivieri EM. Predictive ability of a predischarge hour-specific serum bilirubin for subsequent significant hyperbilirubinemia in healthy term and near-term newborns. Pediatrics . 1999;103:6-14 [Abstract/Free Full Text]
- Stevenson DK, Fanaroff AA, Maisels MJ, et al. Prediction of hyperbilirubinemia in near-term and term infants. Pediatrics . 2001;108:31 -39 [Abstract/Free Full Text]
American Academy of Pediatrics, Provisional Committee for Quality Improvement and Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics . 2004;114:297 -316 [Abstract/Free Full Text]