Changes in the incidence of severe hyperbilirubinemia in the United States following implementation of universal newborn bilirubin screening

Comparison of the incidence of severe hyperbilirubinemia (TSB >25 mg/dL [428 micromol/L]) during three different eras:

Universal bilirubin screening era (dark red bars): Data are from 302,399 newborn infants born at one of the Intermountain Healthcare (IMHC) facilities from 2001 to 2010
Selective testing era (orange bar): Data are from Northern California population (Newman et al) managed soon after the implementation of 1994 AAP guidelines, which endorsed selective newborn bilirubin testing (ie, checking TSB if the newborn appeared jaundiced or had other risk factors) and recommended phototherapy for those with TSB ≥15 mg/dL (257 micromol/L).
Pre-guideline era (yellow bar): Historical data from the era prior to publication of the AAP guidelines. Data are from the seven-year Collaborative Perinatal Project, which was initiated in 1959 and included 41,324 newborn infants with birth weights >2.5 kg. This was prior to availability of phototherapy and most newborns with TSB >20 mg/dL (342 micromol/L) in this era were treated with exchange transfusion.

TSB: total serum bilirubin; AAP: American Academy of Pediatrics.

From: Brites D, Bhutani VK. Pathways involving bilirubin and other brain-injuring agents. In: Clinics in Development Medicine: Cerebral palsy: Science and clinical practice, Dan B, Mayston M, Paneht N, Rosenbloom L (Eds), Mac Keith Press, London 2014. Copyright © 2014 Mac Keith Press. Reproduced with permission of John Wiley & Sons Inc. This image has been provided by or is owned by Wiley. Further permission is needed before it can be downloaded to PowerPoint, printed, shared or emailed. Please contact Wiley's permissions department either via email: permissions@wiley.com or use the RightsLink service by clicking on the 'Request Permission' link accompanying this article on Wiley Online Library (http://onlinelibrary.wiley.com).

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