Significance of pediatrician admission to obstetrics wards rounds in the management of neonatal jaundice

Objective To explore the clinical impact of pediatricians in obstetric ward rounds and standardize the implementation of neonatal jaundice management guidelines for neonatal hyperbilirubinemia. Methods The healthy, full-term infants or late preterm infants form April 2017 to April 2018 were selected and divided into management group (n=3 785) and control group (n=4 131). There was no significant difference in gender, birth weight and gestational age between the two groups. Transcutaneous bilirubin (TcB) and total serum bilirubin monitoring were performed. The incidence of hyperbilirubinemia, rate of rehospitalization of outpatient, serum total bilirubin at admission, rate of compliance with transfusion guidelines, and outpatient follow-up rate were retrospectively reviewed. Results ①The incidence of neonatal hyperbilirubinemia was 16.2% in the management group and 15.6% in the control group, with no statistically significant (χ²=0.551, P=0.446). ②The rate of rehospitalization of outpatient with hyperbilirubinemia was 35.5% in the management group, which was higher than 29.3% in the control group (χ²=5.534, P=0.024). ③ The level of serum total bilirubin was (299.0±27.6) μmol/L in the management group, which was lower than (303.0±31.9) μmol/L in the control group (t=2.380, P=0.022). ④ The rate meeting the standard of blood transfusion was 2.1% in the management group, which was lower than 4.0% in the control group (χ²=3.891, P=0.047). ⑤ The neonatal jaundice outpatient follow-up rate was 82.7% in the management group, which was significantly higher than 54.6% in the control group. ⑥ The risk factors for neonatal jaundice included perinatal factor (38.4%), early breast milk jaundice (23.6%), infection (10.6%), hemolysis (9.1%) and scalp hematoma (4.5%). Conclusion Pediatrician admission to obstetrics wards rounds can standardize and intervene the management of neonatal jaundice in the Department of Obstetrics and avoid severe hyperbilirubinemia by effective follow-up.