title: Extreme hyperbilirubinemia and rescue exchange transfusion in California from 2007 to 2012.
abstract: To evaluate the impact of statewide learning collaboratives that used national guidelines to manage jaundice on the serial prevalence of extreme hyperbilirubinemia (EHB, total bilirubin ⩾25 mg dl(-1)) and exchange transfusions introduced in California Perinatal Quality Care Collaborative (CPQCC) hospitals in 2007.
  
  
  
  Adverse outcomes were retrieved from statewide databases on re-admissions for live births ⩾35 weeks' gestation (2007 to 2012) in diverse CPQCC hospitals. Individual and cumulative select perinatal risk factors and frequencies were the outcomes measures.
  
  
  
  For 3 172 762 babies (2007 to 2012), 92.5% were ⩾35 weeks' gestation. Statewide EHB and exchange rates decreased from 28.2 to 15.3 and 3.6 to 1.9 per 100 000 live births, respectively. From 2007 to 2012, the trends for TB>25 mg dl(-1) rates were -0.92 per 100 000 live births per year (95% CI: -3.71 to 1.87, P=0.41 and R(2)=0.17).
  
  
  
  National guidelines complemented by statewide learning collaboratives can decrease or modify outcomes among all birth facilities and impact clinical practice behavior.
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: V K
authors.initials: VK
authors.lastname: Bhutani
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: N F
authors.initials: NF
authors.lastname: Meng
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Knauer
authors.affiliation: Health Information Solutions, Rocklin, CA, USA.
authors.forename: B H
authors.initials: BH
authors.lastname: Danielsen
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Wong
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: D K
authors.initials: DK
authors.lastname: Stevenson
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.|California Perinatal Quality Care Collaborative, Stanford, CA, USA.
authors.forename: J B
authors.initials: JB
authors.lastname: Gould
mesh_terms: D001663:Bilirubin / Q000097:blood; D002140:California / Q000453:epidemiology; D005078:Exchange Transfusion, Whole Blood / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000453:epidemiology / Q000628:therapy; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000453:epidemiology* / Q000628:therapy; D010359:Patient Readmission / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors
chemical_list: D001663:Bilirubin