Simplifying Hyperbilirubinemia Risk Estimation.

* Abbreviations: AAP — : American Academy of Pediatrics TSB — : total serum bilirubin Δ-TSB — : difference between the predischarge total serum bilirubin and the corresponding AAP phototherapy threshold (in milligrams/deciliter) Jaundice impacts more than half of term and late preterm newborns in the first week of life. Although in most cases, jaundice is benign, the consequences of severe hyperbilirubinemia are debilitating; thus, identification of newborns likely to exceed bilirubin treatment thresholds is needed. The American Academy of Pediatrics (AAP) recommends stratification of predischarge total serum bilirubin (TSB) levels by using the Bhutani Nomogram to help determine the appropriate timing of newborn follow-up. A separate nomogram is then used to determine if an infant meets criteria for phototherapy.1 Kuzniewicz et al2 aim to simplify the process and more precisely determine when a newborn requires outpatient follow-up for jaundice with a simple equation. Starting with a retrospective cohort study of a diverse sample of 148 162 newborns born at ≥35 weeks’ gestation at 11 Kaiser Permanente Northern California facilities from 2012 to 2017, the researchers identified newborns whose TSB measurements did not exceed phototherapy levels and did not receive phototherapy during the birth hospitalization. Using the newborn’s last TSB value before hospital discharge (predischarge TSB), the authors calculated the difference between the predischarge total serum bilirubin and the corresponding American Academy of … Address correspondence to Laura R. Kair, MD, MAS, Department of Pediatrics, University of California, Davis, 2516 Stockton Blvd, Ticon II, Room 341, Sacramento, CA 95817. E-mail: lrkair{at}ucdavis.edu