Effect of the 2022 AAP Guideline for Managing Hyperbilirubinemia in the Newborn.

Abstract

Background and objectives: The American Academy of Pediatrics provides guidelines for managing hyperbilirubinemia in term newborns ≥35 weeks' gestation to prevent kernicterus. In 2022, the AAP revised these guidelines by raising thresholds for serum bilirubin testing and phototherapy. This study compares newborn outcomes before and after implementing the 2022 guidelines.

Methods: A retrospective chart review of 2,087 newborns, with 1,058 in the "before" group, using the 2004 guidelines, and 1,029 in the "after" group using the 2022 guidelines. Data collected included demographics, number of heel sticks for serum bilirubin, incidence of phototherapy, and incidence of readmission for hyperbilirubinemia.

Results: There was a 64% reduction in serum bilirubin draws, a 51% decrease in phototherapy sessions, and a 35% reduction in readmissions for phototherapy in the "after" group.

Conclusions: The 2022 AAP guidelines streamlined the management of hyperbilirubinemia, leading to fewer interventions without affecting patient safety.