Effect of the 2022 AAP Guideline for Managing Hyperbilirubinemia in the Newborn

Abstract

Objective

The American Academy of Pediatrics (AAP) provides guidelines for managing hyperbilirubinemia in term newborns ≥35 weeks' gestation to prevent kernicterus. In 2022, the AAP revised these guidelines by raising thresholds for serum bilirubin testing and phototherapy. This study compares newborn outcomes before and after implementing the 2022 guidelines.

Study Design

A retrospective chart review of 2,087 newborns, with 1,058 in the “before” group, using the 2004 guidelines, and 1,029 in the “after” group, using the 2022 guidelines. Data collected included demographics, number of heel sticks for serum bilirubin, incidence of phototherapy, and incidence of readmission for hyperbilirubinemia.

Results

There was a 64% reduction in serum bilirubin draws, a 51% decrease in phototherapy sessions, and a 35% reduction in readmissions for phototherapy in the “after” group.

Conclusion

The 2022 AAP guidelines streamlined the management of hyperbilirubinemia, leading to fewer interventions without affecting patient safety.

Key Points

• The recent AAP newborn jaundice guidelines result in fewer serum bilirubin levels being drawn.

• The recent AAP newborn jaundice guidelines result in less phototherapy.

• The recent AAP newborn jaundice guidelines result in fewer readmissions for jaundice.

Keywords

hyperbilirubinemia - newborn - American Academy of Pediatrics guidelines - bilirubin management

Publication History

Received: 04 February 2025

Accepted: 22 July 2025

Accepted Manuscript online:
23 July 2025

Article published online:
07 August 2025

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