Experts Still Split on Bilirubin Screening for Newborns

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... universal screening for bilirubin reduced the number of infants who developed severe jaundice, a condition that can lead to seizures and brain damage. But expert opinion and important guidelines are divided on the practice.

Infants born at hospitals with universal bilirubin screening had a 62% lower incidence of total serum bilirubin (TSB) levels exceeding American Academy of Pediatrics (AAP) guidelines compared with those born at facilities without universal screening ...

Babies born at hospitals with routine screening ... received twice as much inpatient phototherapy ... and had slightly longer hospitalizations after birth ... than those in hospitals without routine screening.

... high levels of bilirubin in the body can cause brain damage ... hearing loss, eye muscle problems, physical abnormalities, and even death. The incidence of kernicterus ranges from 0.4 to 2.9 per 100,000 live births ...

... early treatment can decrease the number of infants with elevated serum bilirubin levels, but found inadequate evidence that treating elevated bilirubin levels in term or near-term infants to prevent severe hyperbilirubinemia resulted in the prevention of chronic bilirubin encephalopathy, the greatest danger posed by the condition.

"Evidence about the benefits and harms of screening is lacking," ... "Thus, the USPSTF could not determine the balance of benefits and harms of screening newborn infants to prevent chronic bilirubin encephalopathy."

... "Although screening can predict hyperbilirubinemia, there is no robust evidence to suggest that screening is associated with favorable clinical outcomes," ...

... while routine testing is an imperfect tool, it might prevent some cases of brain damage ...

Melissa Maimann, Essential Birth Consulting 0400 418 448