Related Experiment Video

Updated: Jun 20, 2026

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
11:39

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

Published on: July 11, 2013

Impact of universal bilirubin screening on severe hyperbilirubinemia and phototherapy use

Michael W Kuzniewicz1, Gabriel J Escobar, Thomas B Newman

  • 1Division of Neonatology, Department of Pediatrics, University of California, San Francisco, CA 94143-0748, USA. kuzniewiczm@peds.ucsf.edu

Pediatrics
|September 30, 2009
PubMed

Insights

Universal bilirubin screening significantly reduced severe hyperbilirubinemia in newborns. However, this screening also led to increased use of phototherapy for jaundice management.

Area of Science:

  • Neonatal Medicine
  • Pediatric Care
  • Public Health Screening

Background:

  • Severe hyperbilirubinemia (jaundice) is a common concern in newborns.
  • Effective screening methods are crucial for timely intervention and preventing complications.

Purpose of the Study:

  • To evaluate the impact of universal bilirubin screening on severe hyperbilirubinemia incidence.
  • To assess changes in phototherapy utilization following the implementation of universal screening.

Main Methods:

  • Retrospective cohort study of 358,086 infants (≥35 weeks gestation, ≥2000 g).
  • Data collected on demographics, total serum bilirubin (TSB) levels, and inpatient phototherapy.
  • Comparison of outcomes before and after universal screening implementation.

Main Results:

  • Infants born at facilities with universal screening had a 62% lower incidence of TSB levels exceeding AAP guidelines.
  • Phototherapy use was higher in screened infants (9.1% vs 4.2%).
  • Screening was associated with a significantly lower risk (OR 0.28) of developing high TSB levels.

Conclusions:

  • Universal bilirubin screening effectively reduces severe hyperbilirubinemia.
  • Screening is linked to increased phototherapy use, necessitating careful management guidelines.
  • The study highlights a trade-off between preventing severe jaundice and increased treatment interventions.
Abstract

More Related Videos

Treatment of Platelet Products with Riboflavin and UV Light: Effectiveness Against High Titer Bacterial Contamination10:32

Treatment of Platelet Products with Riboflavin and UV Light: Effectiveness Against High Titer Bacterial Contamination

Published on: August 24, 2015

Related Concept Videos

Jaundice01:25

Jaundice

Jaundice, or icterus, is the yellow discoloration of the skin, sclerae, and mucous membranes. It happens when plasma bilirubin levels rise above 2.5-3 mg/dL, leading to bilirubin deposition in tissue.Bilirubin is a byproduct of hemoglobin degradation. In macrophages, hemoglobin breaks down into globin and heme. Globin is converted into amino acids, while heme is turned into biliverdin by heme oxygenase, which is then reduced to unconjugated bilirubin by biliverdin reductase.Unconjugated...
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test01:22

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow01:26

Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow

Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug binding...