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A review of existing neonatal hyperbilirubinemia guidelines in Indonesia

Mahendra Tri Arif Sampurna1,2, Danny Chandra Pratama2, Visuddho Visuddho3

  • 1Neonatology Division, Department of Pediatrics, Dr Soetomo General Hospital, Faculty of Medicine, Universitas Airlangga, Surbaya, 60115, Indonesia.

F1000Research
|November 29, 2023
PubMed

Insights

Indonesia needs a unified neonatal hyperbilirubinemia guideline. Current guidelines from the Indonesian Pediatric Society, Ministry of Health, and WHO vary, necessitating a new, standardized approach for infant jaundice management.

Area of Science:

  • Neonatal care
  • Pediatrics
  • Public health

Background:

  • Neonatal hyperbilirubinemia is a common inpatient condition in Indonesia.
  • Discrepancies exist among current Indonesian guidelines for managing neonatal hyperbilirubinemia.
  • A unified guideline is needed to standardize care.

Approach:

  • Compared three main neonatal hyperbilirubinemia guidelines used in Indonesia: Indonesian Pediatric Society (IPS), Ministry of Health (MoH), and World Health Organization (WHO).
  • Evaluated guidelines based on prevention, diagnosis, treatment thresholds, and monitoring strategies.
  • Identified key differences in risk assessment and intervention recommendations.

Key Points:

  • MoH and WHO guidelines permit jaundice screening via visual examination (VE) alone.
  • IPS guideline offers comprehensive risk assessment for neonatal jaundice.
  • WHO and IPS recommend combining VE with objective bilirubin measurements, unlike MoH.
  • Phototherapy thresholds differ between WHO and IPS guidelines.

Conclusions:

  • Existing guidelines, particularly the MoH, are outdated and inconsistent.
  • Divergent management approaches create challenges in neonatal hyperbilirubinemia care.
  • A new, uniform guideline is essential for effective and consistent management in Indonesia.
Abstract

Keywords:
LMICicterusneonatesrecommendations

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