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Study Looks at Screening and Bilirubin Encephalopathy

MONDAY, Sept. 28 (HealthDay News) -- The effect of screening for hyperbilirubinemia on the incidence of acute and chronic bilirubin encephalopathy remains unknown, according to research published in the October issue of Pediatrics.

Thomas A. Trikalinos, M.D., of the Institute for Clinical Research and Health Policy Studies in Boston, and colleagues conducted a systematic review of 11 studies on the effectiveness of certain types of screening for preventing neonatal bilirubin encephalopathy, which has been associated with severe neonatal hyperbilirubinemia.

The researchers found that no study assessed the effect of screening on rates of bilirubin encephalopathy. However, screening with risk factors, transcutaneous bilirubin or early total serum bilirubin -- or combinations of these, was found effective in predicting high bilirubin level. Some evidence from uncontrolled studies suggests that screening is associated with a decrease in rates of, and fewer readmissions for, hyperbilirubinemia compared to no screening.

"For practical consideration, studies on the effectiveness of different strategies to reduce the incidence of bilirubin encephalopathy could only rely on a surrogate outcome such as hyperbilirubinemia. Because severe hyperbilirubinemia is a rare event, tens of thousands of infants per arm would be needed to attain statistical power, posing questions on the feasibility of such a study," the authors write.

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