|Title||Extreme hyperbilirubinemia and rescue exchange transfusion in California from 2007 to 2012.|
|Publication Type||Journal Article|
|Year of Publication||2016|
|Authors||Bhutani VK, Meng NF, Knauer Y, Danielsen BH, Wong RJ, Stevenson DK, Gould JB|
|Date Published||2016 10|
|Keywords||Bilirubin, 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 Journal||J Perinatol|
|Grant List||T32 HD007249 / HD / NICHD NIH HHS / United States|