Home- versus hospital-based phototherapy for the treatment of non-haemolytic jaundice in infants at more than 37 weeks' gestation

Abstract

Phototherapy is commonly used for the treatment of neonatal jaundice, and home‐based phototherapy is now being used in certain centres. Home‐based phototherapy offers possible advantages by avoiding prolonged hospital admissions, promoting mother‐infant bonding and reducing hospitalisation costs. Potential problems include increased duration of phototherapy, increased readmission to hospital and increased risk of bilirubin encephalopathy. To compare exclusively home‐based versus exclusively hospital‐based phototherapy or a combination of home‐ and hospital‐based phototherapy for the management of non‐haemolytic jaundice in term infants up to 28 days of age. We planned to include specific subgroups for duration in hospital, method of phototherapy and criteria for readiness for discharge. We searched the Cochrane Neonatal Review Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) January 2013, Issue 1, part of The Cochrane Library, MEDLINE (from 1966 to 15 February 2013), CINAHL (from 1982 to 15 February 2013) and EMBASE (from 1988 to 15 February 2013). We searched for abstracts from the Pediatric Academic Societies' Annual Meetings 2000 to 2013. We searched for ongoing trials on the following websites: ClinicalTrials.gov (http://clinicaltrials.gov/) and Current Controlled Trials (http://controlled‐trials.com/). Randomised and quasi‐randomised studies comparing term infants who received phototherapy exclusively at home versus phototherapy exclusively in the hospital or a combination of the two for non‐haemolytic jaundice. Two review authors independently assessed trial quality and extracted data. No studies that met the predefined eligibility criteria were identified. No high‐quality evidence is currently available to support or refute the practice of home‐based phototherapy for non‐haemolytic jaundice in infants at more than 37 weeks' gestation.