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Extreme hyperbilirubinemia and rescue exchange transfusion in California from 2007 to 2012.

CPQCC Publication
TitleExtreme hyperbilirubinemia and rescue exchange transfusion in California from 2007 to 2012.
Publication TypeJournal Article
Year of Publication2016
AuthorsBhutani VK, Meng NF, Knauer Y, Danielsen BH, Wong RJ, Stevenson DK, Gould JB
JournalJ Perinatol
Date Published2016 10
KeywordsBilirubin, California, Exchange Transfusion, Whole Blood, Female, Gestational Age, Humans, Hyperbilirubinemia, Neonatal, Infant, Newborn, Jaundice, Neonatal, Patient Readmission, Practice Guidelines as Topic, Pregnancy, Prevalence, Risk Factors

OBJECTIVE: To evaluate the impact of statewide learning collaboratives that used national guidelines to manage jaundice on the serial prevalence of extreme hyperbilirubinemia (EHB, total bilirubin ⩾25 mg dl(-1)) and exchange transfusions introduced in California Perinatal Quality Care Collaborative (CPQCC) hospitals in 2007.

STUDY DESIGN: Adverse outcomes were retrieved from statewide databases on re-admissions for live births ⩾35 weeks' gestation (2007 to 2012) in diverse CPQCC hospitals. Individual and cumulative select perinatal risk factors and frequencies were the outcomes measures.

RESULTS: For 3 172 762 babies (2007 to 2012), 92.5% were ⩾35 weeks' gestation. Statewide EHB and exchange rates decreased from 28.2 to 15.3 and 3.6 to 1.9 per 100 000 live births, respectively. From 2007 to 2012, the trends for TB>25 mg dl(-1) rates were -0.92 per 100 000 live births per year (95% CI: -3.71 to 1.87, P=0.41 and R(2)=0.17).

CONCLUSION: National guidelines complemented by statewide learning collaboratives can decrease or modify outcomes among all birth facilities and impact clinical practice behavior.

Alternate JournalJ Perinatol
PubMed ID27442156
Grant ListT32 HD007249 / HD / NICHD NIH HHS / United States