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Rates of phototherapy among ABO-incompatible newborns with a negative direct antiglobulin test

Journal of Perinatology volume 43, pages 1357–1362 (2023)Cite this article

Subjects

Abstract

Objective

We analyze phototherapy rates after implementation of a Hyperbilirubinemia Clinical Pathway (HCP), which placed full-term ABOi DAT negative newborns on the low risk phototherapy nomogram, rather than medium risk, as previously done.

Study design

A chart review was performed for ABOi newborns born ≥36 weeks gestation between January 2020 and October 2021. Primary outcome measures were rates of phototherapy across pre- and post-intervention groups and among DAT negative newborns.

Results

There was an increased proportion of newborns assigned to the low risk curve after the intervention. There were no significant differences in phototherapy rates among the intervention groups, although there was a non-significant decrease in phototherapy rates among DAT negative newborns after the intervention. There were no increases in adverse outcomes.

Conclusions

Providers adhered to the guidelines after implementation of the HCP. ABOi DAT negative newborns can be viewed as low risk for hyperbilirubinemia requiring phototherapy.

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Fig. 1: Outline for inclusion and exclusion criteria for retrospective study.
Fig. 2: Phototherapy outcomes among all ABOi newborns and ABOi DAT negative newborns pre- and post-intervention.

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Data availability

The dataset generated and analyzed during the study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank Elizabeth Woodard, NP, Ginny Combs, MSN, Cheryl Slater, MSN and Jennifer Pfau, MD, for their assistance with implementation of the Hyperbilirubinemia Clinical Pathway at Boston Medical Center.

Funding

This work was supported by a Fred Lovejoy Resident Research and Education Award and the Urban Health and Advocacy Track Grant.

Author information

Authors and Affiliations

  1. Department of Medicine, Boston Children’s Hospital, Boston, MA, USA

    Jonathan M. Gabbay & Elizabeth M. Agneta

  2. Department of Pediatrics, Boston Medical Center, Boston, MA, USA

    Jonathan M. Gabbay, Elizabeth M. Agneta, Bharati Sinha & Tanya Geha

  3. Boston University School of Medicine, Boston, MA, USA

    Simon Turkington

  4. Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA

    Benjamin M. Bajaj

  5. Department of Newborn Medicine, Boston Medical Center, Boston, MA, USA

    Bharati Sinha & Tanya Geha

Authors
  1. Jonathan M. Gabbay
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  2. Elizabeth M. Agneta
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  4. Benjamin M. Bajaj
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  5. Bharati Sinha
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Contributions

Dr JMG conceptualized and designed the study, collected data, drafted the paper and revised the paper. Dr EMA and Mr ST collected data, and reviewed and revised the paper. Mr BMB designed the data collection instruments, carried out analyses, and reviewed and revised the paper. Dr BS designed the study, and reviewed and revised the paper. Dr TG conceptualized and designed the study, coordinated and supervised data collection, and critically reviewed the paper. All authors approved the final paper as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Jonathan M. Gabbay.

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The authors declare no competing interests.

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Gabbay, J.M., Agneta, E.M., Turkington, S. et al. Rates of phototherapy among ABO-incompatible newborns with a negative direct antiglobulin test. J Perinatol 43, 1357–1362 (2023). https://doi.org/10.1038/s41372-023-01650-3

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