The New American Academy of Pediatrics Guidelines for the Management of Neonatal Jaundice: A More Diverse,Individualized and Precision Approach

neonatoloji-4-4-2023

Emel OKULUa

aAnkara University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Türkiye

ABSTRACT
Neonatal jaundice due to hyperbilirubinemia is a common and mostly benign problem. However, there is a risk of acute bilirubin encephalopathy and kernicterus, which are rare but can be a permanently disabling neurological condition. Careful monitoring and effective treatment of hyperbilirubinemia are necessary to reduce these risks. The American Academy of Pediatrics (AAP) revised its clinical practice guideline for neonatal hyperbilirubinemia in newborns ≥35 weeks in 2022, following the 2004 guideline and 2009 clarification. The AAP 2022 guideline included new phototherapy and exchange transfusion nomograms with higher bilirubin thresholds than previous guidelines, risk assessments for escalation-of-care, which is a new definition, universal bilirubin screening procedures, and neurotoxicity risk factors that removed race as a risk factor. The AAP has noted that these guidelines were not developed for use in low- and middle-income countries, where the resources identified for screening, follow-up, and treatment may not be available, and that local consultation is needed in other highincome countries. Therefore, the adaptation of these guideline in our population requires caution and consideration of local knowledge.
Keywords: Jaundice; hyperbilirubinemia; American Academy of Pediatrics; guideline; precision approach

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