{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T11:07:27Z","timestamp":1791803247595,"version":"4.3.4"},"reference-count":16,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,3,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVES:<\/jats:title>\n                  <jats:p>The American Academy of Pediatrics provides little guidance on when to discontinue phototherapy in newborns treated for hyperbilirubinemia. We sought to develop a prediction rule to estimate the probability of rebound hyperbilirubinemia after inpatient phototherapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>Subjects for this retrospective cohort study were infants born in 2012 to 2014 at \u226535 weeks\u2019 gestation at 16 Kaiser Permanente Northern California hospitals who received inpatient phototherapy before age 14 days. We defined rebound as the return of total serum bilirubin (TSB) to phototherapy threshold within 72 hours of phototherapy termination. We used stepwise logistic regression to select predictors of rebound hyperbilirubinemia and devised and validated a prediction score by using split sample validation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>Of the 7048 infants treated with inpatient phototherapy, 4.6% had rebound hyperbilirubinemia. Our prediction score consisted of 3 variables: gestational age &amp;lt;38 weeks (adjusted odds ratio [aOR] 4.7; 95% confidence interval [CI], 3.0\u20137.3), younger age at phototherapy initiation (aOR 0.51 per day; 95% CI, 0.38\u20130.68), and TSB relative to the treatment threshold at phototherapy termination (aOR 1.5 per mg\/dL; 95% CI, 1.4\u20131.7). The model performed well with an area under the receiver operating characteristic curve of 0.89 (95% CI, 0.86\u20130.91) in the derivation data set and 0.88 (95% CI, 0.86\u20130.90) in the validation data set. Approximately 70% of infants had scores &amp;lt;20, which correspond to a &amp;lt;4% probability of rebound hyperbilirubinemia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>The risk of rebound hyperbilirubinemia can be quantified according to an infant\u2019s gestational age, age at phototherapy initiation, and TSB relative to the treatment threshold at phototherapy termination.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2016-2896","type":"journal-article","created":{"date-parts":[[2017,2,14]],"date-time":"2017-02-14T10:03:55Z","timestamp":1487066635000},"source":"Crossref","is-referenced-by-count":52,"title":["A Clinical Prediction Rule for Rebound Hyperbilirubinemia Following Inpatient Phototherapy"],"prefix":"10.1542","volume":"139","author":[{"given":"Pearl W.","family":"Chang","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Seattle Children\u2019s Hospital, Seattle, Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W.","family":"Kuzniewicz","sequence":"additional","affiliation":[{"name":"Division of Research, Kaiser Permanente Northern California, Oakland, California; and"},{"name":"Departments of Pediatrics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles E.","family":"McCulloch","sequence":"additional","affiliation":[{"name":"Epidemiology & Biostatistics, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas B.","family":"Newman","sequence":"additional","affiliation":[{"name":"Division of Research, Kaiser Permanente Northern California, Oakland, California; and"},{"name":"Departments of Pediatrics, and"},{"name":"Epidemiology & Biostatistics, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2017,3,1]]},"reference":[{"issue":"1","key":"2021120907482864700_B1","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1542\/peds.114.1.297","article-title":"Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation.","volume":"114","author":"American Academy of Pediatrics Subcommittee on Hyperbilirubinemia","year":"2004","journal-title":"Pediatrics"},{"issue":"3","key":"2021120907482864700_B2","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/S0095-5108(18)30506-2","article-title":"Phototherapy for neonatal jaundice.","volume":"18","author":"Tan","year":"1991","journal-title":"Clin Perinatol"},{"key":"2021120907482864700_B3","author":"National Institute for Health and Care Excellence","year":"2010"},{"issue":"5","key":"2021120907482864700_B4","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1177\/000992289303200502","article-title":"Phototherapy for neonatal nonhemolytic hyperbilirubinemia. Analysis of rebound and indications for discontinuing therapy.","volume":"32","author":"Lazar","year":"1993","journal-title":"Clin Pediatr (Phila)"},{"issue":"5","key":"2021120907482864700_B5","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1016\/S0022-3476(98)70117-9","article-title":"Rebound bilirubin levels in infants receiving phototherapy.","volume":"133","author":"Yetman","year":"1998","journal-title":"J Pediatr"},{"issue":"11","key":"2021120907482864700_B6","first-page":"1394","article-title":"Rebound hyperbilirubinemia in term infants after phototherapy.","volume":"23","author":"Al-Saedi","year":"2002","journal-title":"Saudi Med J"},{"issue":"5","key":"2021120907482864700_B7","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1093\/tropej\/50.5.309","article-title":"Rebound bilirubin measurement is not required for hyperbilirubinemia regardless of the background attributes of newborns.","volume":"50","author":"Erdeve","year":"2004","journal-title":"J Trop Pediatr"},{"issue":"1","key":"2021120907482864700_B8","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1136\/adc.2005.081224","article-title":"Post-phototherapy neonatal bilirubin rebound: a potential cause of significant hyperbilirubinaemia.","volume":"91","author":"Kaplan","year":"2006","journal-title":"Arch Dis Child"},{"issue":"7","key":"2021120907482864700_B9","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1007\/s13312-010-0133-z","article-title":"Bilirubin rebound after intensive phototherapy for neonatal jaundice.","volume":"47","author":"Bansal","year":"2010","journal-title":"Indian Pediatr"},{"issue":"2","key":"2021120907482864700_B10","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1111\/j.1651-2227.2008.01015.x","article-title":"When should phototherapy be stopped? A pilot study comparing two targets of serum bilirubin concentration.","volume":"98","author":"Barak","year":"2009","journal-title":"Acta Paediatr"},{"issue":"6","key":"2021120907482864700_B11","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1001\/jamapediatrics.2015.4944","article-title":"Association between laboratory calibration of a serum bilirubin assay, neonatal bilirubin levels, and phototherapy use.","volume":"170","author":"Kuzniewicz","year":"2016","journal-title":"JAMA Pediatr"},{"issue":"13","key":"2021120907482864700_B12","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1177\/1536867X1501500406","article-title":"Best subsets variable selection in nonnormal regression models.","volume":"4","author":"Lindsey","year":"2015","journal-title":"Stata J"},{"issue":"7","key":"2021120907482864700_B13","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1001\/archpedi.156.7.669","article-title":"Rebound in serum bilirubin level following intensive phototherapy.","volume":"156","author":"Maisels","year":"2002","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"4","key":"2021120907482864700_B14","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2011-0292","article-title":"Neonatal blue light phototherapy and melanocytic nevi: a twin study.","volume":"128","author":"Csoma","year":"2011","journal-title":"Pediatrics"},{"issue":"6","key":"2021120907482864700_B15","doi-asserted-by":"crossref","first-page":"e20151354","DOI":"10.1542\/peds.2015-1354","article-title":"Retrospective cohort study of phototherapy and childhood cancer in northern California.","volume":"137","author":"Newman","year":"2016","journal-title":"Pediatrics"},{"issue":"6","key":"2021120907482864700_B16","doi-asserted-by":"crossref","first-page":"e20151353","DOI":"10.1542\/peds.2015-1353","article-title":"Neonatal phototherapy and infantile cancer.","volume":"137","author":"Wickremasinghe","year":"2016","journal-title":"Pediatrics"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2016-2896\/1064139\/peds_20162896.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2016-2896\/1064139\/peds_20162896.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T02:28:49Z","timestamp":1639103329000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/139\/3\/e20162896\/53499\/A-Clinical-Prediction-Rule-for-Rebound"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3,1]]},"references-count":16,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2017,3,1]]},"published-print":{"date-parts":[[2017,3,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2016-2896","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3,1]]},"article-number":"e20162896"}}