Hyperbilirubinemia in Premature Infants <35 Weeks’ Gestation: A Chronologic Age Format for Graphing Consensus Guidelines

Consensus guidelines for the management of hyperbilirubinemia in premature infants <35 weeks’ gestation were published in 2012 in response to a request from the American Academy of Pediatrics (AAP). The recommendations were specified according to corrected gestational age (CGA) and are the basis for the widely used graphical tool Premie BiliRecs (PBR). In contrast to the original tabular specifications, the PBR implementation limits decision support to infants with a CGA ≥27 weeks who are ≥48 hours old. This work describes a chronologic age-based graphical format to display the 2012 guidelines according to gestational age at birth, using a design similar to AAP guidelines for infants ≥35 weeks’ gestation. Intended for implementation in an electronic health record, this format addresses limitations of PBR and expands decision support from birth to all premature infants <35 weeks’ GA. Direct comparison with similarly formatted international and institutional guidelines demonstrates similarities and differences among recommendations.