NEONATAL JAUNDICE READMISSIONS TO VICTORIAN SERVICES DURING THE COVID-19 PANDEMIC

ABSTRACT

Background: Extreme neonatal jaundice can cause lifelong neurodevelopmental disabilities and delayed diagnosis is a known risk factor for bilirubin encephalopathy. This study aimed to determine whether the COVID-19 pandemic influenced the rate and severity of readmissions to neonatal services in Melbourne, Australia. Method: Medical records of newborns (gestational age (GA) > 35-weeks) from six hospitals were retrospectively reviewed for the periods April to September of 2018, 2019 and 2020. The rate of readmission was calculated as a percentage of the total number of live births. The GA, postnatal age, jaundice severity (severe jaundice was defined as serum bilirubin >350 μmol/L) and length of stay were calculated as a percentage of readmitted cases. Pearson's chi-squared test was used to calculate the rate and severity of readmission and regression analysis was used to calculate the length of stay and changes across the years. p < 0.05 was considered statistically significant. Results: A total of 1088 newborns were readmitted with jaundice during the study period (Table 1). Among these 60% were male, with 53% > 38-weeks GA and a median age of 4-days (range, 0-14 days), with a statistically significant decrease (p < 0.01) in readmissions during the COVID-19 period. The severity of jaundice presentations was higher in 2020 (p < 0.05) and demonstrated a positive trend towards the increased length of hospital stay (p < 0.01). Conclusion: There was a decrease in readmission rate and increase in severity of neonatal jaundice presentations during the COVID-19 pandemic. This finding highlights the need for robust systems and processes for timely jaundice detection during major health system events.