PM2053: Assessment of Phototherapy Treatment for Delayed Neonatal Jaundice

Background: Jaundice occurs in most newborns and is a common reason for hospital admissions. Neonatal jaundice can last beyond 7 days, but current guidelines do not provide management recommendations for infants older than one week. In this study, we aim to determine if phototherapy improves outcomes in jaundiced neonates aged 7-14 days.

Methods: This multicenter retrospective cohort study used data from the Pediatric Health Information Center. We included term infants aged 7-14 days admitted for neonatal jaundice. We evaluated how phototherapy treatment affected rates of kernicterus, exchange transfusion, IVIG use, readmission, and the average length of stay.

Results: Of 2307 infants aged 7-14 days admitted primarily for neonatal jaundice, 1261 (55%) received phototherapy (Figure 1). No infant in the study was diagnosed with kernicterus or received an exchange transfusion. There was no difference in the rate of IVIG use between the phototherapy and no phototherapy group (5 vs 9, p=0.15). Those who received phototherapy had a shorter average length of stay (1.68 vs 1.71, p=0.0032). There was no difference in readmission rate if infants received phototherapy (14 vs 11, p=0.89).

Conclusion: While there was a small decrease in length of stay for infants treated with phototherapy, it was not associated with a decrease in IVIG use or readmission rates. No infant in this age group was diagnosed with kernicterus or required an exchange transfusion. It does not appear that phototherapy improves important clinical outcomes for infants with breast milk jaundice or delayed physiologic jaundice.