What this Trial Is About

Researchers are investigating the best safe threshold to stop phototherapy in newborn babies who have hemolytic disease of the newborn, a condition that can cause high bilirubin levels. The study aims to compare whether stopping phototherapy at a lower bilirubin level versus a higher bilirubin level affects the chance of rebound hyperbilirubinemia, which is a return of high bilirubin levels after treatment. This trial focuses on full-term and late preterm infants, particularly those born at or after 35 weeks of gestation. The study divides newborns into two groups based on when phototherapy is discontinued: one group stops treatment when bilirubin levels are 50-100 micromol/L below the current standard threshold, and the other stops when levels are about 100 micromol/L below that threshold. Phototherapy is given according to American Academy of Pediatrics (AAP) guidelines, using intensified overhead blue LED lights or intensified 360-degree LED phototherapy if bilirubin levels approach critical exchange transfusion levels. Intravenous immunoglobulin (IVIG) treatment is provided for infants with isoimmune hemolytic disease who do not respond to phototherapy. Immediate exchange transfusion is started if bilirubin levels are above the exchange threshold or if there are signs of acute bilirubin encephalopathy. Participants will be closely monitored for rebound hyperbilirubinemia within 28 days after stopping phototherapy. The study includes regular bilirubin level checks and clinical assessments to evaluate safety and effectiveness of the lower versus higher phototherapy discontinuation thresholds. Researchers will track the need for further treatments such as IVIG or exchange transfusion. The total participation period covers the initial phototherapy treatment and follow-up assessments within the first month of life to ensure babies remain stable and safe after treatment ends.

Safe Threshold to Discontinue Phototherapy in Hemolytic Disease of Newborn