Photo Credit: Smith Assavarujikul
The American Academy of Pediatrics (AAP) updated guidelines for neonatal hyperbilirubinemia, emphasizing elevated bilirubin thresholds, risk assessments, universal screening procedures, and exclusion of race in neurotoxicity risk factors, providing valuable insights for newborn care.
Neonatal jaundice, typically stemming from hyperbilirubinemia, represents a prevalent and generally benign issue in newborns. However, the occurrence of acute bilirubin encephalopathy and kernicterus poses rare yet severe risks, potentially leading to permanent neurological impairment. In 2022, the American Academy of Pediatrics (AAP) introduced significant updates to its clinical practice guideline concerning neonatal hyperbilirubinemia, specifically addressing newborns of at least 35 weeks gestational age.
This revised guideline integrates updated phototherapy and exchange transfusion nomograms featuring elevated bilirubin thresholds compared to previous guidelines. Additionally, it incorporates risk assessments for escalation-of-care, introduces a novel definition and universal procedures for bilirubin screening, and excludes race in neurotoxicity risk factors. However, caution is advised when implementing these updated guidelines in low- and middle-income countries due to potential resource constraints affecting screening, follow-up, and treatment. Therefore, seeking guidance from local experts is crucial when adapting these revised recommendations in such settings.
Source: sciencedirect.com/science/article/pii/S2667009723000970
