title: The impact of phototherapy in the management of neonatal hyperbilirubinemia: comparison of historical cohorts.
abstract: To quantitatively assess the impact of phototherapy (PT) in the prevention of kernicterus we calculated the rate of exchange transfusion (ET) in two large historical cohorts of Greek neonates (birthweight > or = 2.5 kg), one before (period I: 1957-61) and one after (period II: 1980-92) the introduction of PT. Overall, the introduction of PT was associated with a reduction of the rate of ET from 0.43% in period I to 0.05% in period II. The reduction was observed in all etiological categories but was more marked in the ABO-incompatible group. With an estimated rate of kernicterus without treatment of 0.085% (excluding rhesus hemolytic disease of the newborn and prematurity) we estimated that 4.2 and 0.36 infants were treated by ET for each spared kernicterus in periods I and II, respectively. Finally, in period II 185 infants were treated with PT or PT and ET for each spared kernicterus.
authors.affiliation: Department of Pediatrics, New England Medical Center, Boston, Massachusetts, USA.
authors.forename: T
authors.initials: T
authors.lastname: Valaes
authors.forename: C
authors.initials: C
authors.lastname: Koliopoulos
authors.forename: A
authors.initials: A
authors.lastname: Koltsidopoulos
mesh_terms: D015331:Cohort Studies; D005078:Exchange Transfusion, Whole Blood / Q000706:statistics & numerical data; D006115:Greece; D006801:Humans; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000628:therapy*; D007647:Kernicterus / Q000517:prevention & control; D010789:Phototherapy; D016896:Treatment Outcome