A review of existing neonatal hyperbilirubinemia guidelines in Indonesia

Mahendra Tri Arif Sampurna; Danny Chandra Pratama; Visuddho Visuddho; Novita Oktaviana; Achmad Januar Er Putra; Rahmi Zakiyah; Jordy Maulana Ahmad; Risa Etika; Kartika Darma Handayani; Martono Tri Utomo; Dina Angelica; Wurry Ayuningtyas; Toto Wisnu Hendrarto; Rinawati Rohsiswatmo; Setya Wandita; Risma Karina Kaban; Kian Djien Liem

doi:10.12688/f1000research.110550.1

A review of existing neonatal hyperbilirubinemia guidelines in Indonesia

Mahendra Tri Arif Sampurna, Danny Chandra Pratama, Visuddho Visuddho, Novita Oktaviana, Achmad Januar Er Putra, Rahmi Zakiyah, Jordy Maulana Ahmad, Risa Etika, Kartika Darma Handayani, Martono Tri Utomo, Dina Angelica, Wurry Ayuningtyas, Toto Wisnu Hendrarto, Rinawati Rohsiswatmo, Setya Wandita, Risma Karina Kaban, Kian Djien Liem

Research output: Contribution to journal › Review article › peer-review

2 Citations (Scopus)

Abstract

Background: Neonatal hyperbilirubinemia is one of the most common conditions for neonate inpatients. Indonesia faces a major challenge in which different guidelines regarding the management of this condition were present. This study aimed to compare the existing guidelines regarding prevention, diagnosis, treatment and monitoring in order to create the best recommendation for a new hyperbilirubinemia guideline in Indonesia. Methods: Through an earlier survey regarding adherence to the neonatal hyperbilirubinemia guideline, we identified that three main guidelines are being used in Indonesia. These were developed by the Indonesian Pediatric Society (IPS), the Ministry of Health (MoH), and World Health Organization (WHO). In this study, we compared factors such as prevention, monitoring, methods for identifying, risk factors in the development of neonatal jaundice, risk factors that increase brain damage, and intervention treatment threshold in the existing guidelines to determine the best recommendations for a new guideline. Results: The MoH and WHO guidelines allow screening and treatment of hyperbilirubinemia based on visual examination (VE) only. Compared with the MoH and WHO guidelines, risk assessment is comprehensively discussed in the IPS guideline. The MoH guideline recommends further examination of an icteric baby to ensure that the mother has enough milk without measuring the bilirubin level. The MoH guideline recommends referring the baby when it looks yellow on the soles and palms. The WHO and IPS guidelines recommend combining VE with an objective measurement of transcutaneous or serum bilirubin. The threshold to begin phototherapy in the WHO guideline is lower than the IPS guideline while the exchange transfusion threshold in both guidelines are comparably equal. Conclusions: The MoH guideline is outdated. MoH and IPS guidelines are causing differences in approaches to the management hyperbilirubinemia. A new, uniform guideline is required.

Original language	English
Pages (from-to)	1534
Number of pages	1
Journal	F1000Research
Volume	11
DOIs	https://doi.org/10.12688/f1000research.110550.1 https://doi.org/10.12688/f1000research.110550.2
Publication status	Published - 2022

Keywords

icterus
LMIC
neonates
recommendations

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Sampurna, M. T. A., Pratama, D. C., Visuddho, V., Oktaviana, N., Putra, A. J. E., Zakiyah, R., Ahmad, J. M., Etika, R., Handayani, K. D., Utomo, M. T., Angelica, D., Ayuningtyas, W., Hendrarto, T. W., Rohsiswatmo, R., Wandita, S., Kaban, R. K., & Liem, K. D. (2022). A review of existing neonatal hyperbilirubinemia guidelines in Indonesia. F1000Research, 11, 1534. https://doi.org/10.12688/f1000research.110550.1, https://doi.org/10.12688/f1000research.110550.2

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title = "A review of existing neonatal hyperbilirubinemia guidelines in Indonesia",

abstract = "Background: Neonatal hyperbilirubinemia is one of the most common conditions for neonate inpatients. Indonesia faces a major challenge in which different guidelines regarding the management of this condition were present. This study aimed to compare the existing guidelines regarding prevention, diagnosis, treatment and monitoring in order to create the best recommendation for a new hyperbilirubinemia guideline in Indonesia. Methods: Through an earlier survey regarding adherence to the neonatal hyperbilirubinemia guideline, we identified that three main guidelines are being used in Indonesia. These were developed by the Indonesian Pediatric Society (IPS), the Ministry of Health (MoH), and World Health Organization (WHO). In this study, we compared factors such as prevention, monitoring, methods for identifying, risk factors in the development of neonatal jaundice, risk factors that increase brain damage, and intervention treatment threshold in the existing guidelines to determine the best recommendations for a new guideline. Results: The MoH and WHO guidelines allow screening and treatment of hyperbilirubinemia based on visual examination (VE) only. Compared with the MoH and WHO guidelines, risk assessment is comprehensively discussed in the IPS guideline. The MoH guideline recommends further examination of an icteric baby to ensure that the mother has enough milk without measuring the bilirubin level. The MoH guideline recommends referring the baby when it looks yellow on the soles and palms. The WHO and IPS guidelines recommend combining VE with an objective measurement of transcutaneous or serum bilirubin. The threshold to begin phototherapy in the WHO guideline is lower than the IPS guideline while the exchange transfusion threshold in both guidelines are comparably equal. Conclusions: The MoH guideline is outdated. MoH and IPS guidelines are causing differences in approaches to the management hyperbilirubinemia. A new, uniform guideline is required.",

keywords = "icterus, LMIC, neonates, recommendations",

author = "Sampurna, {Mahendra Tri Arif} and Pratama, {Danny Chandra} and Visuddho Visuddho and Novita Oktaviana and Putra, {Achmad Januar Er} and Rahmi Zakiyah and Ahmad, {Jordy Maulana} and Risa Etika and Handayani, {Kartika Darma} and Utomo, {Martono Tri} and Dina Angelica and Wurry Ayuningtyas and Hendrarto, {Toto Wisnu} and Rinawati Rohsiswatmo and Setya Wandita and Kaban, {Risma Karina} and Liem, {Kian Djien}",

note = "Publisher Copyright: Copyright: {\textcopyright} 2023 Sampurna MTA et al.",

year = "2022",

doi = "10.12688/f1000research.110550.1",

language = "English",

volume = "11",

pages = "1534",

journal = "F1000Research",

issn = "2046-1402",

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Sampurna, MTA, Pratama, DC, Visuddho, V, Oktaviana, N, Putra, AJE, Zakiyah, R, Ahmad, JM, Etika, R, Handayani, KD, Utomo, MT, Angelica, D, Ayuningtyas, W, Hendrarto, TW, Rohsiswatmo, R, Wandita, S, Kaban, RK & Liem, KD 2022, 'A review of existing neonatal hyperbilirubinemia guidelines in Indonesia', F1000Research, vol. 11, pp. 1534. https://doi.org/10.12688/f1000research.110550.1, https://doi.org/10.12688/f1000research.110550.2

TY - JOUR

T1 - A review of existing neonatal hyperbilirubinemia guidelines in Indonesia

AU - Sampurna, Mahendra Tri Arif

AU - Pratama, Danny Chandra

AU - Visuddho, Visuddho

AU - Oktaviana, Novita

AU - Putra, Achmad Januar Er

AU - Zakiyah, Rahmi

AU - Ahmad, Jordy Maulana

AU - Etika, Risa

AU - Handayani, Kartika Darma

AU - Utomo, Martono Tri

AU - Angelica, Dina

AU - Ayuningtyas, Wurry

AU - Hendrarto, Toto Wisnu

AU - Rohsiswatmo, Rinawati

AU - Wandita, Setya

AU - Kaban, Risma Karina

AU - Liem, Kian Djien

PY - 2022

Y1 - 2022

N2 - Background: Neonatal hyperbilirubinemia is one of the most common conditions for neonate inpatients. Indonesia faces a major challenge in which different guidelines regarding the management of this condition were present. This study aimed to compare the existing guidelines regarding prevention, diagnosis, treatment and monitoring in order to create the best recommendation for a new hyperbilirubinemia guideline in Indonesia. Methods: Through an earlier survey regarding adherence to the neonatal hyperbilirubinemia guideline, we identified that three main guidelines are being used in Indonesia. These were developed by the Indonesian Pediatric Society (IPS), the Ministry of Health (MoH), and World Health Organization (WHO). In this study, we compared factors such as prevention, monitoring, methods for identifying, risk factors in the development of neonatal jaundice, risk factors that increase brain damage, and intervention treatment threshold in the existing guidelines to determine the best recommendations for a new guideline. Results: The MoH and WHO guidelines allow screening and treatment of hyperbilirubinemia based on visual examination (VE) only. Compared with the MoH and WHO guidelines, risk assessment is comprehensively discussed in the IPS guideline. The MoH guideline recommends further examination of an icteric baby to ensure that the mother has enough milk without measuring the bilirubin level. The MoH guideline recommends referring the baby when it looks yellow on the soles and palms. The WHO and IPS guidelines recommend combining VE with an objective measurement of transcutaneous or serum bilirubin. The threshold to begin phototherapy in the WHO guideline is lower than the IPS guideline while the exchange transfusion threshold in both guidelines are comparably equal. Conclusions: The MoH guideline is outdated. MoH and IPS guidelines are causing differences in approaches to the management hyperbilirubinemia. A new, uniform guideline is required.

AB - Background: Neonatal hyperbilirubinemia is one of the most common conditions for neonate inpatients. Indonesia faces a major challenge in which different guidelines regarding the management of this condition were present. This study aimed to compare the existing guidelines regarding prevention, diagnosis, treatment and monitoring in order to create the best recommendation for a new hyperbilirubinemia guideline in Indonesia. Methods: Through an earlier survey regarding adherence to the neonatal hyperbilirubinemia guideline, we identified that three main guidelines are being used in Indonesia. These were developed by the Indonesian Pediatric Society (IPS), the Ministry of Health (MoH), and World Health Organization (WHO). In this study, we compared factors such as prevention, monitoring, methods for identifying, risk factors in the development of neonatal jaundice, risk factors that increase brain damage, and intervention treatment threshold in the existing guidelines to determine the best recommendations for a new guideline. Results: The MoH and WHO guidelines allow screening and treatment of hyperbilirubinemia based on visual examination (VE) only. Compared with the MoH and WHO guidelines, risk assessment is comprehensively discussed in the IPS guideline. The MoH guideline recommends further examination of an icteric baby to ensure that the mother has enough milk without measuring the bilirubin level. The MoH guideline recommends referring the baby when it looks yellow on the soles and palms. The WHO and IPS guidelines recommend combining VE with an objective measurement of transcutaneous or serum bilirubin. The threshold to begin phototherapy in the WHO guideline is lower than the IPS guideline while the exchange transfusion threshold in both guidelines are comparably equal. Conclusions: The MoH guideline is outdated. MoH and IPS guidelines are causing differences in approaches to the management hyperbilirubinemia. A new, uniform guideline is required.

KW - icterus

KW - LMIC

KW - neonates

KW - recommendations

UR - http://www.scopus.com/inward/record.url?scp=85178230587&partnerID=8YFLogxK

U2 - 10.12688/f1000research.110550.1

DO - 10.12688/f1000research.110550.1

M3 - Review article

C2 - 38025296

AN - SCOPUS:85178230587

SN - 2046-1402

VL - 11

SP - 1534

JO - F1000Research

JF - F1000Research

ER -

A review of existing neonatal hyperbilirubinemia guidelines in Indonesia

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