Main Article Content
Abstract
BACKGROUND
Hyperbilirubinemia is one of the commonest clinical problems encountered in the neonatal period, especially during the first week of life which can be classified into unconjugated & conjugated hyperbilirubinemia. Phototherapy plays an important role in the treatment of neonatal hyperbilirubinemia. The study intended to evaluate changes in serum electrolyte levels in neonates undergoing phototherapy for exaggerated physiological hyperbilirubinemia.
METHODS
A prospective cross-sectional observational study was conducted in a tertiary care teaching hospital from April 2020 to March 2021 on neonates born after achieving gestational age of 28 weeks.
RESULTS
A significant incidence of hypocalcaemia was noted in neonates post phototherapy (19.2 %; P-value < 0.001). The incidence of hypocalcaemia was higher in preterm (31.7 %) than the term (8.6 %) and at low birth (41.7 %) than in normal-weight (10.6 %). It was also found to be much more when the duration of PTH was > 24 hours (28.6 %) as compared to the duration of PTH when less than 24 hours (12.2 %). No adverse events due to hypocalcaemia were noted. The incidence of hyponatraemia and hypokalaemia after phototherapy was found to be non-significant (P values 0.371 and 0.301 respectively) before and after phototherapy.
CONCLUSIONS
The study thus does not recommend any calcium supplementation over and above the prescribed guidelines recommended by AAP and NNF. However, in view of higher incidence, LBW and preterm neonates may be considered for monitoring and calcium prophylaxis on an individual basis.
Keywords
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References
- Cayabyab R, Ramanathan R. High unbound bilirubin for age: a neurotoxin with major effects on the developing brain. Pediatric Research 2019;85(2):183-90.
- Mojtahedi SY, Izadi A, Seirafi G, et al. Risk factors associated with neonatal jaundice: a cross-sectional study from Iran. Open Access Maced J Med Sci 2018;6(8):1387-93.
- Wang J, Guo G, Li A, et al. Challenges of phototherapy for neonatal hyperbilirubinemia. Exp Ther Med 2021;21(3):231.
- Sgro M, Campbell D, Shah V. Incidence and causes of severe neonatal hyperbilirubinemia in Canada. CMAJ 2006;175(6):587-90.
- Hansen TWR. The roles of phototherapy in the crash cart approach to extreme neonatal jaundice. Semin. Perinatol 2011;35(3):171-4.
- Krishna P, Soans ST. Phototherapy induced electrolyte imbalance in hyperbilirubinemia of newborns. International Journal of Current Advanced Research 2018;7(3(L)):11223-8.
- Subhashini B, Vani SAV, Das P, et al. Adverse effects of phototherapy on calcium, magnesium and electrolytes levels in neonatal jaundice. Int J Clin Biochem Res 2019;6(3):275-8.
- Bezboruah G, Majumder AK. Electrolyte imbalances resulting from phototherapy in neonatal hyperbilirubinemia. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) 2019;18(8 Ser-1):51-8.
- Suneja S, Kumawat R, Saxena R. Effect of phototherapy on various biochemical parameters in neonatal hyperbilirubinaemia: a clinical insight. Indian Journal of Neonatal Medicine and Research 2018;6(2):PO13-8.
- Karamifar H, Pishva N, Amirhakimi GH. Prevalence of Phototherapy Induced Hypocalcemia. Iran J Med Sci 2002;27(4):166-8.
- Zecca E, Romagnoli C, Tortorol G. Ineffectiveness of vitamin 25 (OH) D3 in the prevention of hypocalcemia induced by phototherapy. Pediatr Med Chir 1983;5(5):317-9.
- Taheri PA, Sajjadian N, Eivazzadeh B. Prevalence of phototherapy induced hypocalcemia in term neonate. Iran J Pediatr 2013;23(6):710-1.
- Eghbalian F, Monsef A. Phototherapy induced hypocalcemia in icteric newborns. IJMS 2002;27(4):169-71.
- Jain BK, Singh H, Singh D, et al. Phototherapy induced hypocalcemia. Indian Pediatr 1998;35(6):566-7.
- Yadav RK, Sethi RS, Sethi AS, et al. The evaluation of effect of phototherapy on serum calcium level. Peoples J Sci Res 2012;5(2):1-4.
- Arora S, Narang GS, Singh G. Serum calcium levels in preterm and term neonates on phototherapy. J Nepal Paediatr Soc 2014;34(1):24-8.
References
Cayabyab R, Ramanathan R. High unbound bilirubin for age: a neurotoxin with major effects on the developing brain. Pediatric Research 2019;85(2):183-90.
Mojtahedi SY, Izadi A, Seirafi G, et al. Risk factors associated with neonatal jaundice: a cross-sectional study from Iran. Open Access Maced J Med Sci 2018;6(8):1387-93.
Wang J, Guo G, Li A, et al. Challenges of phototherapy for neonatal hyperbilirubinemia. Exp Ther Med 2021;21(3):231.
Sgro M, Campbell D, Shah V. Incidence and causes of severe neonatal hyperbilirubinemia in Canada. CMAJ 2006;175(6):587-90.
Hansen TWR. The roles of phototherapy in the crash cart approach to extreme neonatal jaundice. Semin. Perinatol 2011;35(3):171-4.
Krishna P, Soans ST. Phototherapy induced electrolyte imbalance in hyperbilirubinemia of newborns. International Journal of Current Advanced Research 2018;7(3(L)):11223-8.
Subhashini B, Vani SAV, Das P, et al. Adverse effects of phototherapy on calcium, magnesium and electrolytes levels in neonatal jaundice. Int J Clin Biochem Res 2019;6(3):275-8.
Bezboruah G, Majumder AK. Electrolyte imbalances resulting from phototherapy in neonatal hyperbilirubinemia. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) 2019;18(8 Ser-1):51-8.
Suneja S, Kumawat R, Saxena R. Effect of phototherapy on various biochemical parameters in neonatal hyperbilirubinaemia: a clinical insight. Indian Journal of Neonatal Medicine and Research 2018;6(2):PO13-8.
Karamifar H, Pishva N, Amirhakimi GH. Prevalence of Phototherapy Induced Hypocalcemia. Iran J Med Sci 2002;27(4):166-8.
Zecca E, Romagnoli C, Tortorol G. Ineffectiveness of vitamin 25 (OH) D3 in the prevention of hypocalcemia induced by phototherapy. Pediatr Med Chir 1983;5(5):317-9.
Taheri PA, Sajjadian N, Eivazzadeh B. Prevalence of phototherapy induced hypocalcemia in term neonate. Iran J Pediatr 2013;23(6):710-1.
Eghbalian F, Monsef A. Phototherapy induced hypocalcemia in icteric newborns. IJMS 2002;27(4):169-71.
Jain BK, Singh H, Singh D, et al. Phototherapy induced hypocalcemia. Indian Pediatr 1998;35(6):566-7.
Yadav RK, Sethi RS, Sethi AS, et al. The evaluation of effect of phototherapy on serum calcium level. Peoples J Sci Res 2012;5(2):1-4.
Arora S, Narang GS, Singh G. Serum calcium levels in preterm and term neonates on phototherapy. J Nepal Paediatr Soc 2014;34(1):24-8.