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Subthreshold Phototherapy After Birth Cuts Later Phototherapy

Tx at birth hospitalization can prevent readmission for phototherapy, but tied to unneeded treatment

WEDNESDAY, Feb. 28, 2018 (HealthDay News) — Subthreshold phototherapy during birth hospitalization is associated with reduced readmission for phototherapy, according to a study published online Feb. 26 in JAMA Pediatrics.

Andrea C. Wickremasinghe, M.D., from the Kaiser Permanente Santa Clara Medical Center in California, and colleagues estimated the efficacy of subthreshold phototherapy for newborns with total serum bilirubin levels from 0.1 to 3 mg/dL below the appropriate phototherapy threshold during birth hospitalization. Data were included for 25,895 newborns born at 35 or more weeks’ gestation.

The researchers found that 19.1 percent of the newborns received subthreshold phototherapy; 4.9 percent of these were readmitted for phototherapy compared with 12.8 percent of the untreated newborns (unadjusted odds ratio, 0.35). The correlation was strengthened after adjustment for confounding variables (odds ratio, 0.28). The estimated numbers needed to treat ranged from 60.8 to 6.3 in the lowest versus the highest quintile of predicted risk. Compared with exclusively breastfed newborns, those who received formula feedings had lower adjusted odds of readmission for phototherapy (odds ratio, 0.58 for >0 to <2 formula feedings per day; odds ratio, 0.24 for ≥6 formula feedings per day). There was a 22-hour-longer length of stay in association with subthreshold phototherapy.

“Subthreshold phototherapy during the birth hospitalization is effective in preventing readmissions for phototherapy; however, for each readmission prevented, many newborns require phototherapy who would otherwise not need it,” the authors write.

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