Non-invasive screening and diagnosis of neonatal jaundice

INTERVENTION: 1. Repeated transcutaneous bilirubinometry as a screening tool for jaundice and secondary selective measurement of total serum bilirubin. 2. Application of phototherapy in primary care birth centres if hyperbilirubinaemia is present. Control: 1. Visual assessment of jaundice and selective measurement of total serum bilirubin. 2. Phototherapy in the hospital. CONDITION: Neonatal jaundice, Neonatal hyperbilirubinemia, Neonatal icterus, Hyperbilirubinemia, Hyperbilirubinemia, Phototherapy, Transcutaneous bilirubin measurement, Transcutaneous bilirubinometry, Jaundice ; ; PRIMARY OUTCOME: 1. The proportion of neonates with severe hyperbilirubinaemia. Severe hyperbilirubinaemia is defined as a total serum bilirubin level above the mean of the phototherapy and the exchange transfusion threshold according to the Dutch total serum bilirubin nomogram.; ; 2. The proportion of neonates admitted to the hospital for hyperbilirubinaemia treatment.; SECONDARY OUTCOME: ‐ Highest total serum bilirubin level. ; ; ‐ Proportion of neonates having total serum bilirubin quantified at any time point. ; ; ‐ Number of times blood taken for total serum bilirubin quantification before start of phototherapy. ; ; ‐ Number of times transcutaneous bilirubin is quantified and levels of individual measurements. ; ; ‐ Difference in transcutaneous bilirubin measurement at forehead and sternum (at same time point). ; ; ‐ Proportion of neonates receiving phototherapy. ; ; ‐ Duration (hours) of phototherapy (if relevant). ; ; ‐ Proportion of neonates having a total serum bilirubin level above the exchange transfusion threshold. ; ; ‐ Proportion of neonates who actually received an exchange transfusion. ; ; ‐ Proportion of neonates having kernicterus. ; ; ‐ Duration of hospital stay (if relevant). ; ; ‐ Number of transfers between primary care birth centres/hospitals. ; ; ‐ Number of times paediatrician consulted and outcome of consultation. ; ; ‐ Cost‐effectiveness of both interventions. ; ; ‐ Experience of parents (based on a questionnaire). ; ; ‐ Experience of attending health care personnel (based on a questionnaire). INCLUSION CRITERIA: Neonates are eligible if: ‐ They were born after 35 completed weeks of gestation. ‐ They are admitted in a participating primary care birth centre during the study period within the first week of life. ‐ They are expected to remain admitted for at least two days. ‐ Signed informed consent is available from parent(s).