{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T11:17:32Z","timestamp":1780571852717,"version":"3.54.1"},"reference-count":17,"publisher":"SAGE Publications","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NPM"],"published-print":{"date-parts":[[2022,4,12]]},"abstract":"<jats:p>BACKGROUND: Hyperbilirubinemia (HB), defined as elevated total serum bilirubin (TSB) levels, commonly affects neonates and requires prompt treatment to prevent neurological complications. Up to 10%of neonates experience rebound hyperbilirubinemia (RHB), requiring re-initiation of treatment. Unfortunately, treatment guidelines lack practical recommendations surrounding subthreshold phototherapy, treatment termination, and RHB investigations. We examined local management practices for HB and RHB treatment in a well newborn nursery. As a secondary aim, we investigated the association between treatment practices and RHB rates. METHODS: Retrospective chart review identified neonates treated for hyperbilirubinemia between January 2015 and December 2019 during their birth hospitalization at a tertiary care centre. Standardized data collection sheets were used to record treatment parameters. RESULTS: Over the 5-year period, there were 9683 births and 305 (3.15%) neonates received phototherapy. Of the treated cases, 20\u201325%were subthreshold to practice guideline values. Upon treatment termination 25\u201355%of cases had TSB levels within 3\u200amg\/dL, which may increase the risk of RHB. In our cohort, 20.3%of treated cases experienced one episode of RHB and 3.9%experienced two episodes of RHB. Although clinicians evaluated neonates for RHB 0\u201312 hours following treatment termination prior to discharge, many cases were identified in outpatient settings and required re-admission for phototherapy. CONCLUSION: When managing HB and RHB, treatment practices such as when to terminate treatment in relation to threshold values, and timing of RHB investigations, are largely inconsistent amongst clinicians. Future studies are required to better understand the landscape of hyperbilirubinemia treatment beyond initiation of phototherapy.<\/jats:p>","DOI":"10.3233\/npm-210781","type":"journal-article","created":{"date-parts":[[2021,9,17]],"date-time":"2021-09-17T12:08:40Z","timestamp":1631880520000},"page":"335-343","source":"Crossref","is-referenced-by-count":3,"title":["Treatment practices and implementation of guidelines for hyperbilirubinemia and rebound hyperbilirubinemia"],"prefix":"10.1177","volume":"15","author":[{"given":"Vincent","family":"So","sequence":"first","affiliation":[{"name":"Queen\u2019s School of Medicine, Queen\u2019s University, Kingston, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faiza","family":"Khurshid","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Queen\u2019s University, Kingston, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","reference":[{"key":"10.3233\/NPM-210781_ref1","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/S2352-4642(18)30139-1","article-title":"Neonatal hyperbilirubinaemia: A global perspective","volume":"2","author":"Olusanya","year":"2018","journal-title":"Lancet Child Adolesc Heal"},{"key":"10.3233\/NPM-210781_ref2","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1542\/peds.2008-2980","article-title":"Impact of universal bilirubin screening on severe hyperbilirubinemia and phototherapy use","volume":"124","author":"Kuzniewicz","year":"2009","journal-title":"Pediatrics"},{"key":"10.3233\/NPM-210781_ref3","doi-asserted-by":"crossref","first-page":"1B","DOI":"10.1093\/pch\/12.suppl_B.1B","article-title":"Guidelines for detection, management and prevention of hyperbilirubinemia in term and late preterm newborn infants","volume":"12","author":"Barrington","year":"2007","journal-title":"Paediatr Child Health"},{"key":"10.3233\/NPM-210781_ref4","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1056\/NEJMct0708376","article-title":"Phototherapy for neonatal jaundice","volume":"385","author":"Maisels","year":"2008","journal-title":"N Engl J Med"},{"key":"10.3233\/NPM-210781_ref5","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1002\/ebch.1898","article-title":"Cochrane Review: Prophylactic phototherapy for preventing jaundice in preterm or low birth weight infants","volume":"8","author":"Okwundu","year":"2013","journal-title":"Evidence-Based Child Heal"},{"key":"10.3233\/NPM-210781_ref6","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"},{"key":"10.3233\/NPM-210781_ref7","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","year":"2004","journal-title":"Pediatrics"},{"key":"10.3233\/NPM-210781_ref8","doi-asserted-by":"crossref","first-page":"437","DOI":"10.3122\/jabfm.2012.04.110307","article-title":"Clinician adherence to guideline for phototherapy use in newborns","volume":"25","author":"Madlon-Kay","year":"2012","journal-title":"J Am Board Fam Med"},{"key":"10.3233\/NPM-210781_ref9","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1001\/jamapediatrics.2017.5630","article-title":"Efficacy of subthreshold newborn phototherapy during the birth hospitalization in preventing readmission for phototherapy","volume":"172","author":"Wickremasinghe","year":"2018","journal-title":"JAMA Pediatr"},{"key":"10.3233\/NPM-210781_ref10","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1007\/s00431-011-1454-1","article-title":"The side effects of phototherapy for neonatal jaundice: What do we know? 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A pilot study comparing two targets of serum bilirubin concentration","volume":"98","author":"Barak","year":"2009","journal-title":"Acta Paediatr Int J Paediatr"},{"issue":"3","key":"10.3233\/NPM-210781_ref16","doi-asserted-by":"crossref","first-page":"e2016289","DOI":"10.1542\/peds.2016-2896","article-title":"A Clinical Prediction Rule for Rebound Hyperbilirubinemia Following Inpatient Phototherapy","volume":"139","author":"Chang","year":"2017","journal-title":"Pediatrics"},{"key":"10.3233\/NPM-210781_ref17","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1542\/hpeds.2014-0074","article-title":"The utility of inpatient rebound bilirubin levels in infants readmitted after birth hospitalization for hyperbilirubinemia","volume":"5","author":"Berkwitt","year":"2015","journal-title":"Hosp Pediatr"}],"container-title":["Journal of Neonatal-Perinatal Medicine"],"original-title":[],"link":[{"URL":"https:\/\/content.iospress.com\/download?id=10.3233\/NPM-210781","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T05:41:47Z","timestamp":1777614107000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.medra.org\/servlet\/aliasResolver?alias=iospress&doi=10.3233\/NPM-210781"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,12]]},"references-count":17,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3233\/npm-210781","relation":{},"ISSN":["1934-5798","1878-4429"],"issn-type":[{"value":"1934-5798","type":"print"},{"value":"1878-4429","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,12]]}}}