title: Severe neonatal hyperbilirubinemia in the Netherlands.
abstract: BACKGROUND
  The occurrence of severe neonatal hyperbilirubinemia (SH) is partly attributed to nonhospitalized perinatal care. The Netherlands have a high frequency of home births and nonhospitalized perinatal care, and the incidence of SH is unknown.
  
  
  OBJECTIVE
  To assess the effects of home births and early hospital discharge on the incidence of SH in term-born infants in the Netherlands.
  
  
  METHODS
  In this nationwide prospective surveillance study between 2005 and 2009, infants (≥37 weeks GA) were included if total serum bilirubin (TSB) was ≥500 µmol/l or if they received an exchange transfusion when TSB was ≥340 µmol/l.
  
  
  RESULTS
  Seventy-one infants had SH (incidence 10.4/100,000); 43 had a TSB ≥500 μmol/l (incidence 6.3/100,000) and 45 (63%) underwent an exchange transfusion. 26% of the infants with SH were born at home, which is similar to 22% of all term infants who are born at home in the Netherlands (p = 0.41). Maximum TSB levels were similar in infants born at home (523 ± 114 μmol/l) and infants born in hospital (510 ± 123 μmol/l; p = 0.70). Of the 51 infants born in hospital, 33 were discharged and readmitted with SH, with maximal TSB levels (567 ± 114 μmol/l), which were higher than in infants who remained hospitalized (406 ± 47 μmol/l; p = 0.0001).
  
  
  CONCLUSIONS
  The incidence of severe hyperbilirubinemia in term-born infants in the Netherlands is 10.4 per 100,000, which is similar to other developed countries. Home birth and early hospital discharge do not necessarily lead to a higher incidence of SH, provided that perinatal home care is well organized.
authors.affiliation: Department of Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Gotink
authors.forename: Manon J
authors.initials: MJ
authors.lastname: Benders
authors.forename: Selma W
authors.initials: SW
authors.lastname: Lavrijsen
authors.forename: Rob
authors.initials: R
authors.lastname: Rodrigues Pereira
authors.forename: Christian V
authors.initials: CV
authors.lastname: Hulzebos
authors.forename: Peter H
authors.initials: PH
authors.lastname: Dijk
mesh_terms: D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D005078:Exchange Transfusion, Whole Blood; D005865:Gestational Age; D006700:Home Childbirth; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D015994:Incidence; D007231:Infant, Newborn; D009426:Netherlands / Q000453:epidemiology; D010351:Patient Discharge; D018743:Perinatal Care; D011446:Prospective Studies; D012042:Registries; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D015415:Biomarkers; D001663:Bilirubin