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Severe Neonatal Hyperbilirubinemia Decreased after the 2007 Canadian Guidelines

Michael Sgro1, Sharmilaa Kandasamy2, Vibhuti Shah3

  • 1Keenan Research Center of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Pediatrics, St. Michael's Hospital, Toronto, Ontario, Canada; Division of Neonatology, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.

The Journal of Pediatrics
|February 8, 2016
PubMed

Insights

Severe neonatal hyperbilirubinemia incidence in Canada decreased significantly after 2007 guideline implementation. The minimum estimated incidence is now 1 in 8352 live births, a notable improvement in infant health outcomes.

Area of Science:

  • Neonatal Medicine
  • Pediatrics
  • Public Health

Background:

  • Severe neonatal hyperbilirubinemia poses significant health risks to newborns.
  • The Canadian Pediatric Society (CPS) established guidelines in 2007 to manage hyperbilirubinemia.
  • Previous incidence rates in Canada were reported at 1 in 2480.

Purpose of the Study:

  • To estimate the incidence of severe neonatal hyperbilirubinemia in Canada between 2011 and 2013.
  • To assess the impact of the 2007 CPS guidelines on hyperbilirubinemia rates.

Main Methods:

  • Prospective surveillance of term infants (≤ 60 days) with peak serum total bilirubin > 425 μmol/L or exchange transfusion.
  • Exclusion criteria included rhesus isoimmunization and prematurity (< 35 weeks gestation).
  • Data collected via the Canadian Pediatric Surveillance Program from 2011-2013.

Main Results:

  • Ninety-one cases of severe neonatal hyperbilirubinemia were confirmed.
  • The incidence was estimated at a minimum of 1 in 8352 live births.
  • Infants were 3.5 times less likely to be diagnosed with severe hyperbilirubinemia compared to 2002-2004.

Conclusions:

  • The incidence of severe neonatal hyperbilirubinemia in Canada has substantially decreased.
  • Implementation of CPS guidelines and increased physician awareness are likely contributors to this decline.
  • This trend suggests improved management and outcomes for neonatal hyperbilirubinemia in Canada.
Abstract

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