Department of Pediatrics, College of Medicine, Baghdad University, Baghdad, 12221, Iraq.
Department of Pediatrics, Children Welfare Teaching Hospital, Baghdad, 12221, Iraq.
F1000Res. 2020 Jun 3;9:504. doi: 10.12688/f1000research.24258.1. eCollection 2020.
Neonatal jaundice is a physiological process that occurs normally for every infant to a varying degree. In some cases, this process becomes pathological and imposes an increased risk of morbidity and mortality for the infant. The aim of this study was to assess the adherence level of various physicians to different guidelines of management of neonatal hyperbilirubinemia in Iraq. An observational cross-sectional study was conducted in multiple outpatient clinics in various Iraqi provinces, from February 2018 to February 2019. The study involved 130 physicians, who were divided into emergency physicians (EPs), general practitioners (GPs), and pediatricians (PDs), and assessed their compliance to guidelines for management of neonatal hyperbilirubinemia using a questionnaire, which included providing the correct management for a test case scenario. PDs had significantly longer discharge times compared to EPs and GPs. In total, 91.7% of PDs always tested the neonate for bilirubin levels before discharge, while 5.5% of GPs and 0% of EP did so. Regarding follow-up visits, 16.7%, 4.8% and 45.2% of PDs, EPs and GPs, respectively, scheduled a follow-up between 49-72 hours; 47.6% and 38.1% of EPs scheduled a follow-up at ≤24 hours and 25-48 hours, respectively. In addition, 91.7% of PDs gave the correct answer for the management of the test case scenario, followed by 58.9% of GPs, and 38.1% of EPs. About half of PDs extended neonates length of stay beyond 48 hours. GPs and EPs show lower adherence levels for the management of neonatal jaundice than PDs, which indicates that these physicians adhere well to current management guidelines from the WHO, AAP, and NICE.
新生儿黄疸是一种生理过程，每个婴儿都会在不同程度上发生。在某些情况下，这个过程会变得病态，并增加婴儿发病和死亡的风险。本研究旨在评估伊拉克不同医生对新生儿高胆红素血症管理的各种指南的依从程度。一项观察性横断面研究于 2018 年 2 月至 2019 年 2 月在伊拉克多个省份的多个门诊诊所进行。研究涉及 130 名医生，他们被分为急诊医生 (EPs)、全科医生 (GPs) 和儿科医生 (PDs)，并使用问卷评估他们对新生儿高胆红素血症管理指南的依从性，问卷包括为测试案例提供正确的管理。PDs 的出院时间明显长于 EPs 和 GPs。总的来说，91.7%的 PDs 在出院前总是为新生儿检查胆红素水平，而 5.5%的 GPs 和 0%的 EP 这样做。关于随访，PDs、EPs 和 GPs 分别有 16.7%、4.8%和 45.2%安排在 49-72 小时之间进行随访；47.6%和 38.1%的 EPs 分别安排在 24 小时内和 25-48 小时内进行随访。此外，91.7%的 PDs 对测试案例的管理给出了正确答案，其次是 58.9%的 GPs 和 38.1%的 EPs。大约一半的 PDs 将新生儿的住院时间延长至 48 小时以上。GPs 和 EPs 在管理新生儿黄疸方面的依从性低于 PDs，这表明这些医生很好地遵守了世界卫生组织、美国儿科学会和英国国家卫生与临床优化研究所的现行管理指南。
