Seminars in perinatology · 2026
Identifying best practices for global standardization of home phototherapy for neonatal hyperbilirubinemia: An international comparative study.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
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Spaan Jessie, Hulzebos Christian V, Been Jasper V, Ohlin Andreas, Cummings Erin, Pettersson Miriam, Thomas Mercy
Аннотация
OBJECTIVE: To identify insights from home phototherapy protocols for neonatal hyperbilirubinemia in Australia, the Netherlands, and Sweden, and to inform future efforts toward standardizing a curriculum and implementation framework.
METHODS: We performed a cross-country comparative study of national and local guidelines and protocols on home phototherapy. Documents were collected through publicly available resources and professional networks. Data were extracted on four domains: patient selection and eligibility criteria, parental education, logistics and care delivery models, and safety aspects.
RESULTS: Twenty protocols were included: six from Australia, six from the Netherland, and eight from Sweden. While variation in eligibility criteria for home phototherapy was observed across protocols. Eligible neonates were generally required to be ≥36 weeks' gestation, ≥48 h postnatal age, clinically well, with total serum bilirubin (TSB) well below exchange transfusion thresholds, and without evidence of hemolysis. Care delivery models varied, across midwifery-led, nurse-led, and hospital-led approaches. Escalation criteria were present in five (25%) protocols and inconsistently defined. All protocols emphasized structured parental education delivered by qualified nurses and recommended daily TSB monitoring.
CONCLUSION: Home phototherapy protocols demonstrate consistent emphasis on TSB monitoring and parental education, with more variation in eligibility, care delivery models and escalation criteria. A Delphi consensus study is recommended to address observed variability and to inform the development of a globally applicable framework for different healthcare systems.
METHODS: We performed a cross-country comparative study of national and local guidelines and protocols on home phototherapy. Documents were collected through publicly available resources and professional networks. Data were extracted on four domains: patient selection and eligibility criteria, parental education, logistics and care delivery models, and safety aspects.
RESULTS: Twenty protocols were included: six from Australia, six from the Netherland, and eight from Sweden. While variation in eligibility criteria for home phototherapy was observed across protocols. Eligible neonates were generally required to be ≥36 weeks' gestation, ≥48 h postnatal age, clinically well, with total serum bilirubin (TSB) well below exchange transfusion thresholds, and without evidence of hemolysis. Care delivery models varied, across midwifery-led, nurse-led, and hospital-led approaches. Escalation criteria were present in five (25%) protocols and inconsistently defined. All protocols emphasized structured parental education delivered by qualified nurses and recommended daily TSB monitoring.
CONCLUSION: Home phototherapy protocols demonstrate consistent emphasis on TSB monitoring and parental education, with more variation in eligibility, care delivery models and escalation criteria. A Delphi consensus study is recommended to address observed variability and to inform the development of a globally applicable framework for different healthcare systems.