Comparison of Electrolyte Changes in Term Neonates before and after Phototherapy

Background Jaundice or hyperbilirubinemia is one of the most common problems occurring in the neonatal period. Phototherapy plays a major role in its treatment. However, this treatment modality may itself result in complications which even contribute to the development of convulsions. Hence in this study changes in serum electrolytes are evaluated in term neonates receiving phototherapy for unconjugated hyperbilirubinemia. Aim and objective To estimate and compare the serum electrolytes levels in term neonates with unconjugated hyperbilirubinemia before and after phototherapy. Method After getting Ethical Committee approval informed, written consent, medical history were obtained from the neonate's mother, general examination, systemic examination was carried out for 30 full-term jaundiced neonates receiving phototherapy. Laboratory tests including total serum bilirubin by Diazo method, serum calcium level by Arsenazo III method and serum electrolytes by Ion selective electrodes analyser were performed before and after 48 hours of phototherapy. Blood samples taken from the newborn babies before the commencement of phototherapy was regarded as control group. Blood samples taken 48 hours following establishment of phototherapy was regarded as study group. Results Statistical analysis was done using Paired t test There was a significant decrease in serum bilirubin after 48 hours of phototherapy. This was accompanied by a significant decrease in serum calcium levels with a p value of 0.014 in eighteen neonates (60%). None of the neonates were clinically symptomatic. There was no alteration in the values of serum bicarbonate, chloride, sodium and potassium. Conclusion This study shows a decrease in serum calcium levels in term infants exposed to phototherapy. Hence serum calcium, sodium, potassium, chloride, bicarbonate along with routine measurement of serum bilirubin should be monitored regularly for neonates receiving phototherapy to prevent the development of complications.