Treatment Of Neonatal Jaundice Research Articles

Umbilical cord blood acid-base analysis and the development of significant hyperbilirubinemia in near-term and term newborns: a cohort study

BackgroundThe recognition, follow-up, and early treatment of neonatal jaundice has become more difficult, since the earlier discharge of newborns from hospitals has become common practice. Since intrapartum hypoxic stress has been pointed as predisposing factor for the occurrence of hyperbilirubinemia risk, we tested the association with the cord blood acid-base index tests.MethodsA cohort of healthy term and near-term newborns underwent umbilical cord hemogasanalysis at birth and capillary heel total serum bilirubin (TSB) pre-discharge, scheduled at 36 h of life, to define the risk of significant hyperbilirubinemia, defined as >9 mg/dL TSB level, ≥ 75th percentile on nomogram of Bhutani et al.ResultsIt was found that among 537 studied neonates, 133 (24.8%) had pre-discharge TSB levels of >9 mg/dL. When the cord blood gas analysis index tests were compared, their acidemia levels were significantly higher than those of neonates with normal TSB levels: HCO3− (20.71 ± 2.37 vs. 21.29 ± 2.25 mEq/L, p < 0.010), base deficit (−3.52 ± 3.188 vs. -2.68 ± 3.266 mEq/L, p < 0.010), and lactacidemia (3.84 ± 1.864 vs. 3.39 ± 1.737 mEq/L, p < 0.012), respectively. However, logistic regression analysis showed that base deficit was the strongest index of the pre-discharge hyperbilirubinemia risk (OR, 95% CI 0.593; 0.411–0.856), and the hyperbilirubinemia risk increased by 40% with the decrease of 1 mEq/L of base deficit.ConclusionsUmbilical cord blood acidemia and lactacidemia are significant indexes of adaptive mechanisms at birth. The base deficit provides the strongest association with future development of high bilirubin on an hour specific bilirubin nomogram generating risk stratification score in term and near-term neonates.

The lowering of bilirubin levels in patients with neonatal jaundice using massage therapy: A randomized, double-blind clinical trial

ObjectiveDue to the effects of massage on various laboratory parameters (including those related to jaundice) in infants and the expansion of existing studies to achieve effective and safe therapy in the treatment of neonatal jaundice, this study aimed to investigate the effect of massage on bilirubin levels in cases of neonatal jaundice. MethodsIn this study, 134 patients were randomly assigned to either an intervention group (massage combined with phototherapy, n=67) or a control group (phototherapy only, n=67). In both groups, serum total bilirubin level and frequency of daily bowel movements were measured and compared during each of the first four days of treatment. ResultsBaseline levels of bilirubin were similar between the two groups (P>0.05). During the measurements obtained post-intervention, significant differences surfaces between the two groups in bilirubin levels and frequency of daily bowel movements (P<0.05 for both). No significant relationship was observed during days 1 and 2 of massage therapy between daily frequency of bowel movements and serum bilirubin level (P>0.05); this relationship became significant during the third and fourth days (P<0.05). ConclusionMassage therapy combined with phototherapy is an effective method for reducing serum total bilirubin in infants with neonatal jaundice.

Efficacy analysis of early intervention in 240 cases with neonatal jaundice

Objective To explore the early intervention time and method for neonatal jaundice, to prevent excessive treatment and delay treatment. Methods From July 2014 to June 2014, 240 full term neonates with high bilirubin value were divided into treatment group and observation group.The treatment group was given blue light treatment, the observation group was given general treatment such as intestinal probiotics, Yinzhihuang oral liquid.The treatment time, duration of jaundice of newborn babies, full refund yellow bilirubin value of time and follow-up at the 28th day were observed in two groups. Results In the two groups after treatment, without conversion of blood treatment in 1 case, 1 case of bilirubin encephalopathy.In the control group, the treatment time, the duration of jaundice, jaundice time were (7.84±1.79)d, (10.40±1.30)d, (13.85±1.88)d, which in the treatment group were (4.55±1.63)d, (8.70±1.50)d, (11.12±1.65)d respectively, there were significant differences between the two groups(t=14.74, 9.36, 11.70, all P 0.05). Conclusion The key of neonatal jaundice treatment is prevent the happening of the bilirubin encephalopathy, as long as jaundice intervention recommendation should be timely intervened.Blue light is the first selection of neonatal jaundice intervention method, treatment effect is exact; Full moon to the health of more than 3 days, total bilirubin blood although has reached the blue-ray standard treatment, on the premise of strict monitoring of bilirubin, can temporarily not blue light. Key words: Jaundice; Infant, newborn; Early intervention

신생아 황달의 예방적 치료에 대한 연구동향

Introduction Jaundice is one of the most common conditions found in neonatal period. Phototherapy is one of the main treatments for neonatal jaundice. However, several adverse effects of the phototherapy have been reported, including DNA damage recently. Therefore, a variety of treatments have been conducted to shorten the duration of phototherapy. Meanwhile, it has been hardly tried to prevent neonatal jaundice, but diverse approaches have been tried in traditional Chinese medicine (TCM) for many years. Therefore, this study aims to analyze the studies for the treatments to prevent neonatal jaundice based on TCM. Materials and Methods Various literatures have been searched via CNKI, and PubMed using the terms "neonatal jaundice" (新生儿黄疸, 胎黃, 胎疸) in category of 'Traditional Chinese Medicine', 'Traditional Chinese Medicinal Herbs' and 'Combination of Traditional Chinese Medicine With Western Medicine'. The search range included randomized controlled trials (RCTs), controlled clinical trials (CCTs), case reports, reviews and animal experiments published from 2013 to 2015. Results A total of 104 studies were found. 93 articles were excluded by reviewing the titles and abstracts. Out of the remaining 11 studies, 9 articles were RCTs, 2 articles were CCTs. The treatment used in neonatal babies in the studies were, using herbal remedies (meditation 5, bath 3 and retention enema 1) and the acupressure. All treatments were initiated within the first 24-48 hours after their birth. Then, there was a study that the subjects taken the herbal medicine were women during pregnancy. The outcome assessments used were the serum total bilirubin (TB), transcutaneous bilirubin measurement (TCB), the incidence of the hyperbilirubinemia, the duration time of the jaundice. Especially, TB, TCB and the incidence of the hyperbilirubinemia have decreased significantly more than that of the control group in the most of the results. No severe adverse events were reported in all articles reviewed. Conclusions Conventional treatment such as, herbal medicine in TCM, seems to be the effective way to prevent neonatal jaundice or hyperbilirubinemia. Therefore, the conventional treatment may be favorable choice for preventive treatment for neonatal jaundice.

Ethnomedicine for neonatal jaundice: A cross-sectional survey in Qom, Iran

Ethnopharmacological relevanceTraditional Medicine (TM) is popularly used for neonatal jaundice in Iran. Objectiveto provides evidence for characteristics of traditional medicine use in the treatment of neonatal jaundice in Qom, Iran. Materials and methodsField surveys were carried out during July 2015 - August 2015 in Qom through structured questionnaire in Persian from 212 parents of children with neonatal jaundice. All plant species recorded for the treatment of neonatal jaundice were sampled. Samples were identified by a botanist and obtained a voucher specimens number and deposited in the Shiraz School of Pharmacy Herbarium. The information such as scientific name, family, local name, parts used and preparation method were provided. The Use Value (UV), Frequency of Citation (FC), Relative Frequency of Citation (RFC) and Relative Family Importance Value (FIV) are also calculated. ResultsIn total, 165 (78%) of participants reported the use of traditional methods for their neonates. The use of herbal remedies was the most popular form of these traditional interventions. A total of 8 plant species belonging to 7 families were identified. Cotoneaster nummularioides Pojark. Cichorium intybus L. Alhagi maurorum Medik. Descurainia sophia (L.) Webb ex Prantl were most frequent herbs used by neonates and their feeding mother to treat jaundice. Manna was the most popular plant part and distillation and soaking were most frequent preparation methods in these patients. The use of TM in these patients is associated with their previous experience on TM use and their view on its potential risk. ConclusionsThis study provided information on the prevalence, associated factors and characteristics of traditional medicine use along with ethnomedicinal knowledge from Qom in Iran on neonatal jaundice.

Neonates with sickle cell disease are vulnerable to blue light phototherapy-induced oxidative stress and proinflammatory cytokine elevations

Sickle cell disease is a frequent genetic anomaly characterized by altered molecular structure of hemoglobin resulting into crescent-like deformation of the red blood corpuscles. Neonatal jaundice is a frequent co-morbidity in sickle cell disease. Phototherapy induces isomerization of bilirubin rendering it extractable through urine and hence it is used as a routine treatment of neonatal jaundice. An exposure to light phototherapy as a treatment of neonatal jaundice induces oxidative stress. It is hypothesized that such exposure of neonates with sickle cell disease to the blue light phototherapy as a treatment of neonatal jaundice induces severe oxidative stress and increases the levels of proinflammatory cytokines. This hypothesis is supported with two case studies of sickle cell disease suffering neonates who were exposed to blue light phototherapy to treat jaundice. In both these cases, exposure to phototherapy induced oxidative stress (increased lipid peroxidation and superoxide dismutase, slight change in activity of catalase and GSH) and elevated the levels of proinflammatory cytokine (TNFα, IL-1, and IL-6) in the sickle cell disease suffering neonates. These observations warrant further investigations to determine the consequences and clinical significance of the blue phototherapy-induced oxidative and proinflammatory stress in Sickle cell disease suffering neonates exposed to phototherapy as a treatment of jaundice.

Phototherapy for the Treatment of Neonatal Jaundice and Breastfeeding Duration and Exclusivity.

Because neonatal jaundice remains one of the most commonly treated conditions of the newborn infant, it is important to assess the unintended consequences of treatment with phototherapy. The objective of this study was to evaluate whether treatment with phototherapy affects breastfeeding duration in newborns >35 weeks gestation. We analyzed data from the Infant Feeding Practices Study II. The exposure of interest was treatment of neonatal jaundice with phototherapy. The outcomes of interest were any breastfeeding through 12 months and exclusive breastfeeding through 4 months. Logistic regression models were developed to evaluate the association between the exposure and outcomes of interest. All models were adjusted for maternal age, race, education, household income, and gestational age, as well as for several potential markers of suboptimal breastfeeding. Our study included 4,441 infants, of which 220 (5%) received phototherapy. We found no difference in the likelihood of any breastfeeding through 9 months of age, however, by 12 months, infants exposed to phototherapy were less likely to still be breastfed than those who were not exposed (adjusted odds ratio [aOR] 0.58, 95% confidence interval [95% CI] 0.37-0.92). Infants exposed to phototherapy were less likely to be exclusively breastfed throughout the first 4 months of life. Although phototherapy use did not substantially impact rates of any breastfeeding during the first year, it was associated with decreased rates of exclusive breastfeeding in the first 4 months of life. This suggests that we need to tailor messaging to mothers of infants receiving phototherapy to promote exclusive breastfeeding.

Medicinal Plants for Treatment of Neonatal Jaundice by Community of Attars (Traditional Healers) of Several Urban Areas in Mazandaran Province, Northern of Iran

Medicinal Plants for Treatment of Neonatal Jaundice by Community of Attars (Traditional Healers) of Several Urban Areas in Mazandaran Province, Northern of Iran

Cotoneaster: A Safe and Easy Way to Reduce Neonatal Jaundice.

Consumption of cotoneaster may reduce neonatal jaundice. Hence this study was undertaken to determine the effect of mothers' cotoneaster consumption on treatment of their neonates' jaundice. In this randomized clinical trial study, 120 neonates with jaundice referred to a hospital in southwest Iran were enrolled by nonprobability sampling and divided randomly into four groups. In the first group both mothers and neonates received cotoneaster; in the second group only mothers; in the third group only neonates; and in the fourth group the neonates received distilled water as placebo. Phototherapy was done under the same condition for all neonates. The reduction of bilirubin was significantly higher in treatment groups compared to control group (p<0.05). Bilirubin in the group of neonates whose mothers consumed cotoneaster was less compared to control group at 24 and 36 hours (p<0.05) and the highest reduction in bilirubin was observed in the first group. The mean duration of hospitalization was longer for the control group (p<0.05). Consumption of cotoneaster by both mothers and neonates caused a decrease in neonatal jaundice more rapidly compared to other groups and decreased the duration of hospitalization. Cotoneaster consumption by mothers, neonates, or both may be useful in treatment of neonatal jaundice.

Can use of low-cost white reflecting curtains increase the efficacy of phototherapy?

Context: In the face of a steep rise in the rate of bilirubin in neonates, we often seek improvisations to increase the efficacy of phototherapy machines. In addition, in resource-limited setup, a need is felt for the methods of reducing the duration of phototherapy so that the same machine can be used for more number of neonates. Aim: To study the effect of using white reflecting curtains around phototherapy machines on the efficacy of phototherapy for the treatment of neonatal jaundice. Settings and Design: Double-blind, parallel, randomized controlled trial. Level 2 Neonatal Intensive Care Unit and Neonatal Ward of a tertiary care hospital between June 2011 and May 2012. Subjects and Methods: About 102 term neonates with jaundice were randomized into two groups of 51 neonates each. Group A (the study group) received curtains and Group B (the control group) did not receive curtains during phototherapy. Two phototherapy units were designed so that the white curtains could be hung or removed as required. Along with baseline variables including blood count, reticulocyte count, and G6PD, total serum bilirubin (TSB) was measured for each neonate at 4, 12, and 24 h from the initiation of phototherapy. The primary outcome measure was the mean difference in TSB measured at baseline and after 4, 12, and 24 h of phototherapy. The secondary outcome was the duration of phototherapy in hours and also the mean difference in bilirubin between 12 and 24 h. Results: The mean bilirubin concentration of Group A was significantly less (17.42 ± 1.04 mg/dL at 4 h, 14.52 ± 1.05 mg/dL at 12 h, and 11.33 ± 1.11 mg/dL at 24 h of phototherapy) than Group B (18.02 ± 1.13 mg/dL at 4 h, 17.6 ± 1.09 mg/dL at 12 h, and 16.65 ± 1.11 mg/dL at 24 h) with similar bilirubin concentrations initially. The mean duration of phototherapy in Group A (28.87 ± 4.11 h) was significantly less than Group B (51.14 ± 18.62 h) (P < 0.01). Conclusions : Using white reflecting curtains significantly reduces the mean bilirubin concentration and the duration of phototherapy in jaundiced neonates.

The evaluation of the implementation level of nurses working in neonatal intensive care unit in the treatment of neonatal jaundice

The evaluation of the implementation level of nurses working in neonatal intensive care unit in the treatment of neonatal jaundice

Factors associated with the incidence of acute bilirubin encephalopathy in Nigerian population

Acute bilirubin encephalopathy (ABE) is still a major and common health problem in developing countries in spite of the availability and efficacy of phototherapy and exchange blood transfusion. In developing countries, the prevalence of kernicterus has not shown any reduction because many babies with jaundice present very late in well established kernicterus. The study was done to determine the factors responsible for the late presentation of neonatal jaundice and development of ABE among the patients presenting with this condition in our health facility. All newborns presenting with ABE at the special care baby unit of the Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria were prospectively studied. The diagnosis of ABE was made clinically if there were neurologic abnormalities associated with hyperbilirubinemia. Twenty-eight (3.2%) of 882 babies admitted over 3 yr had ABE. There were 21 males, 7 females, and the male: female ratio 3:1. Twenty-two (78.6%) of the mothers saw at least one health worker more than 24 hr before presentation. Three (10.4%) other mothers who noticed the jaundice did not initiate any treatment while the remaining three (10.4%) mothers did not notice the jaundice in their babies until they presented at the health facility with the complaint of failure to suck. Prescribed medications before presentation were oral antibiotics, hematinics and gentamicin injections, a solution of Naphthalene balls in water and an extract of local herbs made from Pawpaw leaves. Causes of jaundice were septicemia, G6PD deficiency, ABO incompatibility, low birth weight and rhesus isoimmunization in decreasing order of frequency. Maternal factors include low socioeconomic status, teenage and low parity statuses of the mothers. Inappropriate treatment of neonatal jaundice by health workers was also one of the underlying reasons. Therefore, there is need to raise the level of awareness in the community of the occurrence and dangers of neonatal jaundice and its appropriate treatment. Health workers themselves need education and training in the early recognition and treatment of neonatal jaundice.

СУЧАСНІ ПІДХОДИ ДО ВИВЧЕННЯ ФОТОТЕРАПІЇ У НОВОНАРОДЖЕНИХ

&lt;p&gt;Система підготовки сімейних лікарів передбачає підвищення якості освіти шляхом впровадження навчальних програм, що відповідають сучасному рівню розвитку науки згідно з основними критеріями професійної компетентності. Фототерапія є найбільш ефективним і широко використовуваним методом консервативного лікування у новонароджених з неонатальною жовтяницею. У статті розглянута доцільність фототерапії в лікуванні неонатальних жовтяниць, дана характеристика основних методів фототерапії, сучасні рекомендації щодо раціонального використання.&lt;/p&gt;

Phototherapy: A Simple and Safe Treatment for Neonatal Jaundice

Phototherapy: A simple and safe treatment for Neonatal Jaundice. Jaundice is a common finding in premature and full term newborns. Phototherapy has been widely used in the management of Neonatal unconjugated Hyperbilirubinemia for over five decades. Phototherapy devices include Fluorescent, Halogen, Fiberoptic or Light-Emitting Diode light sources. Safety issues and possible complications of phototherapy are discussed. It is a non invasive, safe and easily available therapy worldwide. This review will focus on the use of phototherapy in newborn nurseries.

Scoparone interferes with STAT3-induced proliferation of vascular smooth muscle cells.

Scoparone, which is a major constituent of Artemisia capillaries, has been identified as an anticoagulant, hypolipidemic, vasorelaxant, anti-oxidant and anti-inflammatory drug, and it is used for the traditional treatment of neonatal jaundice. Therefore, we hypothesized that scoparone could suppress the proliferation of VSMCs by interfering with STAT3 signaling. We found that the proliferation of these cells was significantly attenuated by scoparone in a dose-dependent manner. Scoparone markedly reduced the serum-stimulated accumulation of cells in the S phase and concomitantly increased the proportion of cells in the G0/G1 phase, which was consistent with the reduced expression of cyclin D1, phosphorylated Rb and survivin in the VSMCs. Cell adhesion markers, such as MCP-1 and ICAM-1, were significantly reduced by scoparone. Interestingly, this compound attenuated the increase in cyclin D promoter activity by inhibiting the activities of both the WT and active forms of STAT3. Similarly, the expression of a cell proliferation marker induced by PDGF was decreased by scoparone with no change in the phosphorylation of JAK2 or Src. On the basis of the immunofluorescence staining results, STAT3 proteins phosphorylated by PDGF were predominantly localized to the nucleus and were markedly reduced in the scoparone-treated cells. In summary, scoparone blocks the accumulation of STAT3 transported from the cytosol to the nucleus, leading to the suppression of VSMC proliferation through G1 phase arrest and the inhibition of Rb phosphorylation. This activity occurs independent of the form of STAT3 and upstream of kinases, such as Jak and Src, which are correlated with abnormal vascular remodeling due to the presence of an excess of growth factors following vascular injury. These data provide convincing evidence that scoparone may be a new preventative agent for the treatment of cardiovascular diseases.

Step towards Multiplatform Framework for Supporting Pediatric and Neonatology Care Unit Decision Process

Abstract Children are an especially vulnerable population, particularly in respect to drug administration. It is estimated that neonatal and pediatric patients are at least three times more vulnerable to damage due to adverse events and medication errors than adults are. With the development of this framework, it is intended the provision of a Clinical Decision Support System based on a prototype already tested in a real environment. The framework will include features such as preparation of Total Parenteral Nutrition prescriptions, table pediatric and neonatal emergency drugs, medical scales of morbidity and mortality, anthropometry percentiles (weight, length/height, head circumference and BMI), utilities for supporting medical decision on the treatment of neonatal jaundice and anemia and support for technical procedures and other calculators and widespread use tools. The solution in development means an extension of INTCare project. The main goal is to provide an approach to get the functionality at all times of clinical practice and outside the hospital environment for dissemination, education and simulation of hypothetical situations. The aim is also to develop an area for the study and analysis of information and extraction of knowledge from the data collected by the use of the system. This paper presents the architecture, their requirements and functionalities and a SWOT analysis of the solution proposed.

Evaluation of phototherapy with reflectors: A randomized controlled trial.

Background and objectivesNeonatal jaundice is one of the most prevalent clinical conditions requiring evaluation and management within the first few days of life. Phototherapy is the single most common intervention used for the treatment of neonatal jaundice. The aim of our study was to evaluate the efficacy and tolerability of phototherapy with reflectors compared to conventional phototherapy in controlling neonatal hyperbilirubinaemia.Patients and methodsIn this randomized controlled study, we studied neonates for one year (from June 2010 to June 2011) who were full term and healthy with uncomplicated jaundice and who were admitted to the neonatal intensive care unit (NICU) of El-Nasr General Hospital, Port-Said, Egypt. The subjects were randomized in two groups: group A (n = 30) received phototherapy with reflectors and group B (n = 30) received conventional phototherapy. Serum bilirubin levels were measured on admission and every 12 h thereafter. With declining readings, bilirubin was measured once daily until hospital discharge.ResultsThere was no significant difference in total serum bilirubin on admission between the two groups. On discharge, bilirubin levels significantly decreased in group A compared to group B. There was a reduction in the duration of the hospital stay in group A compared to group B. The only observed complication in the groups was hyperthermia, which was not significantly different between the two groups.ConclusionThe present study examined the efficacy and tolerability of phototherapy with reflectors in comparison to conventional phototherapy and found that phototherapy with reflectors was significantly better at controlling bilirubin levels in neonates with indirect hyperbilirubinaemia and at shortening hospitalization time.

Clinical study of Saccharomyces boulardii in the treatment of neonatal jaundice

Objective To investigate the effect of Saccharomyces boulardii in the treatment of neonatal jaundice.Methods 108 neonatal jaundice patients were randomly assigned to two groups.The control group received conventional treatment while the experimental group received conventional treatment,plus Saccharomyces boulardii powder.Serum bilirubin levels of both groups were detected before and after their treatments,thus to study the effect of Saccharomyces boulardii.Results After a 3-day treatment,the control group had a Serum Bilirubin level of (150.5 ± 40.6) μ mol/L while the experimental group got a level of (127.8 ± 48.5) μ mol/L.The difference was statistically significant at(P ＜ 0.05).After 5 days' treatment,the Bilirubin levels of the control group were at (66 ± 32.5) μ mol/L and those of the experimental group were at (42 ± 26.2) μ mol/L.The difference between both groups was statistically significant at (P ＜ 0.01).An everage Icteric subsidise period for the control group was(5.8 ± 1.4) d while that for the experimental group was (4.1 ± 1.1) d.The difference was statistically significant at(P ＜ 0.05).So Bilirubin levels of the experimental group reduced quicker and better.Conclusion Saccharomyces boulardii has auxo-action to the excretion of bilirubin.It clinically helps to treat neonatal jaundice. Key words: Saccharomyces boulardii; Neonatal jaundice; Nilirubin

Home- versus hospital-based phototherapy for the treatment of non-haemolytic jaundice in infants at more than 37 weeks' gestation.

Phototherapy is commonly used for the treatment of neonatal jaundice, and home-based phototherapy is now being used in certain centres. Home-based phototherapy offers possible advantages by avoiding prolonged hospital admissions, promoting mother-infant bonding and reducing hospitalisation costs. Potential problems include increased duration of phototherapy, increased readmission to hospital and increased risk of bilirubin encephalopathy. To compare exclusively home-based versus exclusively hospital-based phototherapy or a combination of home- and hospital-based phototherapy for the management of non-haemolytic jaundice in term infants up to 28 days of age. We planned to include specific subgroups for duration in hospital, method of phototherapy and criteria for readiness for discharge. We searched the Cochrane Neonatal Review Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) January 2013, Issue 1, part of The Cochrane Library, MEDLINE (from 1966 to 15 February 2013), CINAHL (from 1982 to 15 February 2013) and EMBASE (from 1988 to 15 February 2013). We searched for abstracts from the Pediatric Academic Societies' Annual Meetings 2000 to 2013. We searched for ongoing trials on the following websites: ClinicalTrials.gov (http://clinicaltrials.gov/) and Current Controlled Trials (http://controlled-trials.com/). Randomised and quasi-randomised studies comparing term infants who received phototherapy exclusively at home versus phototherapy exclusively in the hospital or a combination of the two for non-haemolytic jaundice. Two review authors independently assessed trial quality and extracted data. No studies that met the predefined eligibility criteria were identified. No high-quality evidence is currently available to support or refute the practice of home-based phototherapy for non-haemolytic jaundice in infants at more than 37 weeks' gestation.

46: Impact of Adherence to Guidelines for Screening and Treatment of Neonatal Jaundice on Peak Bilirubin

46: Impact of Adherence to Guidelines for Screening and Treatment of Neonatal Jaundice on Peak Bilirubin