Effect of Phototherapy on Biochemical Markers of Neonates with Unconjugated Hyperbilirubinemia

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.