Increased prevalence of severe neonatal hyperbilirubinaemia during social distancing

Mokha, Sonam; Heintz, Chana; Agrawal, Vikash; Reynolds, Anne Marie; Berkelhamer, Sara

doi:10.1111/jpc.15881

Cited by 7 publications

(3 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Pandemic-specific factors may have contributed to our findings as the risk of newborn rehospitalization may have changed during this time. While some studies suggest that the frequency of overall post-discharge newborn rehospitalization did not change during the pandemic [ 28 , 29 ], there have been reports of increased rehospitalization risk in some subgroups such as those born to nulliparous mothers [ 30 ] and those readmitted for hyperbilirubinemia [ 31 ]. One nation-wide study from England found that while acute care presentations decreased by 16.7% overall during vs. before the pandemic, attendance for feeding problems and neonatal jaundice increased by 7.5% and 12.8% respectively [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Newborn readmissions and virtual primary care delivery: a population-based case-control study

Cohen,

Stukel,

Wang

et al. 2024

BMC Prim. Care

View full text Add to dashboard Cite

Background Early post-discharge assessments for newborns are recommended. Virtual care has become more prevalent during the pandemic, providing an opportunity to better understand its impact on the quality of post-discharge newborn care. The objective of this study was to understand whether primary care visit modality (in-person vs. virtual) is associated with early newborn hospital readmissions and emergency department (ED) visits. Methods We conducted a population-based, case-control study using linked health administrative databases between September 1, 2020 and March 31, 2022 in Ontario, Canada. We compared the modality of primary care visits among cases (hospital readmission within 14 days of life) and controls (newborns without a readmission), matched on infant sex, gestational age, and maternal parity. We included an alternative definition of cases as a composite of either a newborn hospital readmission or emergency department (ED) visit or in-hospital death within the first 14 days of life. Conditional logistic regression models were used to model odds ratios (ORs), comparing those exposed to a virtual visit versus in-person visit, adjusting for infant birth weight, birth hospitalization length of stay, neighbourhood level material deprivation, rurality and presence of active maternal comorbidities. Results Among 73,324 eligible newborns, 2,220 experienced a hospital readmission within 14 days of life and were matched to 8,880 controls. Jaundice was the primary reason for readmission (75% of readmissions). Compared to newborns who were seen in-person post-discharge, newborns who were seen virtually had higher odds of hospital readmission (adjusted odds ratio [aOR] 1.41 (95% CI 1.09, 1.83); the magnitude of effect was not different using the composite outcome (aOR 1.35, 95% CI 1.05, 1.75). Conclusions Newborns who receive a virtual post-discharge visit are more likely than those who receive an in-person visit to require hospital readmission.

show abstract

Section: Discussionmentioning

confidence: 99%

Newborn readmissions and virtual primary care delivery: a population-based case-control study

Cohen,

Stukel,

Wang

et al. 2024

BMC Prim. Care

View full text Add to dashboard Cite

show abstract

“…This defect results from structural malformation or altered elasticity of the ligaments that normally fix the spleen below the left dome of the diaphragm. 1 Clinical presentation is highly variable, and diagnosis may represent an incidental finding in asymptomatic patients. Nevertheless, patients may present with an acute abdomen due to splenic torsion or with chronic/intermittent abdominal pain deriving from partial torsion and spontaneous de-torsion of the spleen.…”

Section: Dear Editor Acute Abdomen Due To Torsion Of a Wandering Sple...mentioning

confidence: 99%

Severity of Hyperbilirubinaemia

Manzar

2022

J Paediatrics Child Health

View full text Add to dashboard Cite

I read with interest the article by Mokha et al. 1 entitled 'Increased prevalence of severe neonatal hyperbilirubinaemia during social distancing'. The title is misleading as the authors did not define what was meant by the severity of hyperbilirubinaemia. Looking at the data presented in the study, the pandemic group had less severe hyperbilirubinaemia, and better clinical and laboratory profiles of hyperbilirubinaemia compared to the pre-pandemic group (Table 1). The pandemic group had lower mean peak bilirubin level, less exchange level bilirubin, fewer days of phototherapy, and less requirement for intravenous immunoglobulin.The other inference that needs clarification is the role of lactation support. The authors noted a better rate of exclusively breastfeeding (BF) in the COVID era group (87.5%) as compared to the pre-pandemic rates (81.5%). They stated that access to lactation support during the stay-at-home mandates was limited due to the lack of in-person visits and quoted references from systematic reviews that professional lactation support is an effective method to help improve BF rates, its duration and delay cessation. 2,3 The data of improved BF rates (87.5%) in the stay-at-home mandates period was contrary to these statements.

show abstract

“…Most of the severe cases occur in low-and middle-income countries. In addition, shortened stays at maternity wards after delivery are shown to increase the risk of hospital readmission for NNJ, which was further exacerbated during the COVID-19 pandemic [16,17]. To reduce the adverse consequences of NHB, timely detection of infants with the condition is important [18].…”

Section: Introductionmentioning

confidence: 99%

Iterative Development, Validation, and Certification of a Smartphone System to Assess Neonatal Jaundice: Development and Usability Study

Aune¹,

Vartdal²,

Jimenez³

et al. 2023

JMIR Pediatr Parent

View full text Add to dashboard Cite

Background Medical device development is an area facing multiple challenges, resulting in a high number of products not reaching the clinical setting. Neonatal hyperbilirubinemia, manifesting as neonatal jaundice (NNJ), is an important cause of newborn morbidity and mortality. It is important to identify infants with neonatal hyperbilirubinemia at an early stage, but currently there is a lack of tools that are both accurate and affordable. Objective This study aimed to develop a novel system to assess the presence of NNJ. The device should provide accurate results, be approved as a medical device, be easy to use, and be produced at a price that is affordable even in low-resource settings. Methods We used an iterative approach to develop a smartphone-based system to detect the presence of NNJ. We performed technical development, followed by clinical and usability testing in parallel, after which we initiated the regulatory processes for certification. We updated the system in each iteration, and the final version underwent a clinical validation study on healthy term newborns aged 1 to 15 days before all documentation was submitted for conformity assessment to obtain Conformité Européenne (CE) certification. We developed a system that incorporates a smartphone app, a color calibration card, and a server. Results Three iterations of the smartphone-based system were developed; the final version was approved as a medical device after complying with Medical Device Regulation guidelines. A total of 201 infants were included in the validation study. Bilirubin values using the system highly correlated with total serum or plasma bilirubin levels (r=0.84). The system had a high sensitivity (94%) to detect severe jaundice, defined as total serum or plasma bilirubin >250 µmol/L, and maintained a high specificity (71%). Conclusions Our smartphone-based system has a high potential as a tool for identifying NNJ. An iterative approach to product development, conducted by working on different tasks in parallel, resulted in a functional and successful product. By adhering to the requirements for regulatory approval from the beginning of the project, we were able to develop a market-ready mobile health solution.

show abstract

Increased prevalence of severe neonatal hyperbilirubinaemia during social distancing

Cited by 7 publications

References 17 publications

Newborn readmissions and virtual primary care delivery: a population-based case-control study

Newborn readmissions and virtual primary care delivery: a population-based case-control study

Severity of Hyperbilirubinaemia

Iterative Development, Validation, and Certification of a Smartphone System to Assess Neonatal Jaundice: Development and Usability Study

Contact Info

Product

Resources

About