Grant: CIHR Fellowship

Newborn jaundice is a common condition that is usually benign and resolves without treatment. Unfortunately, in rare cases severe jaundice can cause permanent brain damage. When jaundice is severe enough to require treatment, timely initiation of therapy can prevent long term consequences. Concern that babies with jaundice requiring treatment were not being identified in a timely manner led the Canadian Paediatric Society (CPS) to release guidelines in 2007 that recommend screening every newborn for jaundice before discharge from hospital. There is debate in the research literature about whether this is the best approach for preventing the serious but uncommon harm that can be caused by severe jaundice. My research will examine the impact that the guidelines have had within the province of Ontario. I will investigate how the CPS guidelines have been implemented in Ontario hospitals and the impact that this has had on the treatments and services received by newborns. I will also examine the whether the guidelines have reduced socioeconomic disparities in newborn access to primary health care following discharge from hospital. My research will provide evidence that will help us to understand how effective the guidelines have been in ensuring that newborns receive appropriate preventive follow-up care in the first week of life. My findings also will be useful in identifying potential strategies to improve efforts to prevent the adverse consequences of severe jaundice and to reduce health disparity, and will inform policy development regarding the delivery of health services to newborns.