Pettersson Miriam, Lai Cecilia, Ohlin Andreas
Department of Paediatrics, Faculty of Medicine and Health, Örebro University Hospital, S-701 85, Örebro, Sweden.
Värnamo Hospital, Värnamo, Sweden.
Eur J Pediatr. 2025 Jul 31;184(8):515. doi: 10.1007/s00431-025-06353-9.
To examine how many patients received home phototherapy and describe the major reasons for admission to hospital for phototherapy. The study was performed as a retrospective population-based observational study. All newborns at Örebro University Hospital born in October 2019-March 2023 ≥ gestational week 36 + 0 and having performed phototherapy were included. The primary outcome was the proportion of newborns receiving hospital vs home phototherapy. Secondary outcomes were the reasons for not performing home phototherapy. Further secondary outcomes were the number of readmissions (failed home treatments) and the number of infants with bilirubin > 425 µmol/L. In total, 492 patients were included. Of these, 256 (52%) received home phototherapy (180 exclusively, and 76 for part of the treatment); 236 (48%) received phototherapy exclusively in hospital. Among the 302 (236 + 66) patients in whom home phototherapy was not primarily performed, the most common reasons were haemolytic disease (35%) and the need for the use of multiple phototherapy devices (26%). In total, 14% received hospital phototherapy for various other reasons, such as concerns regarding breastfeeding or poor weight gain of the baby.
In this retrospective study, we found that approximately 50% of full-term infants with neonatal hyperbilirubinaemia were suitable for home phototherapy. The most common reasons for not receiving home phototherapy in our population were haemolytic disease and severe hyperbilirubinaemia. These results indicate what may be expected when planning to start a home phototherapy programme.
• Phototherapy at home is considered a safe alternative to hospital treatment for well-selected patients, but the proportion of suitable patients has not been studied.
• This study shows that approximately 50% of all full-term newborns with hyperbilirubinaemia can safely be treated at home. • The most common contraindications to home phototherapy are haemolytic disease and need for intensive phototherapy.
为了研究有多少患者接受了家庭光疗，并描述光疗住院的主要原因。本研究作为一项基于人群的回顾性观察性研究进行。纳入了2019年10月至2023年3月在厄勒布鲁大学医院出生、孕周≥36 + 0且接受过光疗的所有新生儿。主要结局是接受医院光疗与家庭光疗的新生儿比例。次要结局是未进行家庭光疗的原因。进一步的次要结局是再次入院（家庭治疗失败）的次数以及胆红素>425 µmol/L的婴儿数量。总共纳入了492例患者。其中，256例（52%）接受了家庭光疗（180例全程接受，76例部分治疗阶段接受）；236例（48%）仅在医院接受光疗。在302例（236 + 66）未主要进行家庭光疗的患者中，最常见的原因是溶血病（35%）和需要使用多个光疗设备（26%）。总共14%的患者因各种其他原因接受了医院光疗，例如对母乳喂养的担忧或婴儿体重增加不佳。
在这项回顾性研究中，我们发现约50%的足月新生儿高胆红素血症患者适合家庭光疗。在我们的研究人群中，未接受家庭光疗的最常见原因是溶血病和严重高胆红素血症。这些结果表明了在计划启动家庭光疗项目时可能的预期情况。
• 对于精心挑选的患者，家庭光疗被认为是医院治疗的一种安全替代方法，但适合患者的比例尚未得到研究。
• 本研究表明，约50%的所有足月高胆红素血症新生儿可以在家中安全治疗。• 家庭光疗最常见的禁忌症是溶血病和需要强化光疗。
