The outcomes of neonatal jaundice management in Phrachomklao Hospital based on the 2004 and 2022 American Academy of Pediatrics, Clinical Practice Guidelines

Abstract

Background: Neonatal jaundice affects approximately half of all term infants. According to the American Academy of Pediatrics (AAP), the guidelines for treating neonatal jaundice were updated in 2022, prompting hospitals to implement these changes beginning January 1, 2023.

Objective: To study the outcomes of neonatal jaundice after changing the Clinical Practice Guidelines from year 2004 to year 2022

Methods: A retrospective study was condueted by revieweing the medical records of 3,000 infants born between January 1, 2022, and March 31, 2024. The participants were divided into two groups: 1,500 infants born before January 1, 2023, who received treatment according to the 2004 guidelines, and 1,500 infants born after January 1, 2023, who followed the 2022 treatment guidelines. The jaundice levels of the infants were assessed by measuring microbilirubin levels from heel prick blood tests.
Results: The duration of hospital stay of infants treated according to the 2004 guidelines (n=1,500) and the 2022 guidelines (n=1,500) were 3.4±1.3 days and 3.2±1.0 days, respectively (p value <0.01). The rate of readmission due to jaundice was consistent for both groups at 1.5% (p value 1.00). The rates of phototherapy were 18.2% and 15.3% for the group using the 2004 guidelines and the 2022 guidelines (p value 0.40). The rates of blood exchange therapy were minimal in both group  (p value 1.00).

Conclusion: Implementation of the 2022 AAP guidelines, which raised bilirubin thresholds for initiating phototherapy and exchange transfusion, resulted in shorter hospital stay without increasing readmission rates or the need for intensive treatments.