Hour-Specific Risk for Neonatal Hyperbilirubinemia
Predicts risk of hyperbilirubinemia in neonates.
- Use in otherwise healthy neonates ≥35 weeks gestational age (GA) at the time of discharge. Do not use in neonates with positive direct Coombs test, or in those requiring phototherapy before 60 hours of age. Do not use to determine need for exchange transfusion.
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The recommendations listed here for starting phototherapy are based on AAP guidelines. Always use clinical judgment, in addition to considering evidence-based clinical guidelines, in making treatment decisions.
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The risk calculator is one of two clinical options recommended by the AAP for risk assessment (either clinical risk factors alone or in combination with the risk calculator).
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Most important clinical risk factors to consider include: breastfeeding, GA <38 weeks, significant jaundice in a sibling (defined as requiring phototherapy), and jaundice noted before discharge (Newman 2000).
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An infant whose predischarge total serum bilirubin is in the low risk zone is at very low risk for developing severe hyperbilirubinemia.
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Appropriate follow up after discharge must be ensured regardless of method of risk assessment used.
|
Infant discharged |
Should be seen by age |
|
Before 24 hrs |
72 hrs |
|
Between 24 and 48 hrs |
96 hrs |
|
Between 48 and 72 hrs |
120 hrs |
From AAP guidelines.
Clinical judgment should guide follow up. Neonates at higher risk and with clinical risk factors may be followed earlier.