Readmission rates before and after the implementation of 2022 revised AAP clinical practice guidelines for the management of neonatal hyperbilirubinemia - a single center study.

objectiveTo determine if implementing the revised 2022 AAP hyperbilirubinemia guidelines had an impact on post-discharge clinic visits and Neonatal Intensive Care Unit readmissions related to hyperbilirubinemia.

methodsA single-center retrospective study at a birth hospital including a level III NICU. Data was collected on all newborns, who were born at 35 weeks or more gestational age, (inborn and outborn infants), one year before (September 2021-August 2022, period 1) and one year after (September 2022-August 2023, period 2) the implementation of the revised AAP clinical guidelines. Patient charts were reviewed to collect demographic information, serial bilirubin levels, use of phototherapy, discharge bilirubin levels, bilirubin checks as an outpatient, and readmission secondary to hyperbilirubinemia.

resultsA total of 1577 infants were included in our study. Period 1 had 763 infants and period 2 had 814 infants. In period 2, there was a statistically significant decrease in the rate of hyperbilirubinemia diagnosis by 6.6%, a reduction in the use of phototherapy before discharge by 8.4%, and a reduction in the number of TSB checks >6 in the first week of postnatal life by about 4%. Importantly, there was no increase in post-discharge clinic visits for hyperbilirubinemia or readmission rate in period 2.

conclusionImplementation of the 2022 revised AAP guidelines for neonatal hyperbilirubinemia led to reduced diagnosis, phototherapy use during birth hospitalization and fewer TSB checks in the first week of life, without increasing readmission rates or post-discharge clinic visits for jaundice.