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Analysis of the direct antiglobulin test for rates of phototherapy among ABO-incompatible newborns

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Abstract Objective: We analyze phototherapy rates after implementation of a Hyperbilirubinemia Clinical Pathway (HCP), which placed ABOi newborns with negative DAT on the low risk phototherapy nomogram, rather than medium risk, as previously done. Study Design: A chart review was performed for ABOi newborns born > 36 weeks gestation between January 2020 and October 2021. Primary outcome measures were rates of phototherapy across pre- and post-intervention groups and between DAT negative and DAT positive newborns. Results: There were no phototherapy rate differences among the intervention groups, including among DAT negative newborns. DAT positive newborns had increased rates of phototherapy only in the post-intervention group, which was no longer significant when stratified by risk curve. Conclusions: Providers adhered to the guidelines, although there were no changes in rates of phototherapy. We show that among ABOi newborns, differing risk curve assignments based on DAT status does not appear to impact rates of phototherapy.
Title: Analysis of the direct antiglobulin test for rates of phototherapy among ABO-incompatible newborns
Description:
Abstract Objective: We analyze phototherapy rates after implementation of a Hyperbilirubinemia Clinical Pathway (HCP), which placed ABOi newborns with negative DAT on the low risk phototherapy nomogram, rather than medium risk, as previously done.
Study Design: A chart review was performed for ABOi newborns born > 36 weeks gestation between January 2020 and October 2021.
Primary outcome measures were rates of phototherapy across pre- and post-intervention groups and between DAT negative and DAT positive newborns.
Results: There were no phototherapy rate differences among the intervention groups, including among DAT negative newborns.
DAT positive newborns had increased rates of phototherapy only in the post-intervention group, which was no longer significant when stratified by risk curve.
Conclusions: Providers adhered to the guidelines, although there were no changes in rates of phototherapy.
We show that among ABOi newborns, differing risk curve assignments based on DAT status does not appear to impact rates of phototherapy.

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