The Effect of Phototherapy on Serum Calcium in Neonates with Indirect Hyperbilirubinemia

Background: Neonatal jaundice is considrable problem in neonatal nursery .It occures in around 60 % of full term and 80 % of preterm. It might be physiological or pathological, indirect or direct hyperbilirubinemia. If unconjugated hyperbilirubinemia is untreated, it is possibly results in hazardous effect [kernicterus]. Phototherapy is an important method for treatment of hyperbilirubinemia, which is proved to be a good and effective option of management in cases of unconjugated hyperbilirubinemia. However, it is not a definitely safe intervention, it might cause many undesired effects. Hypocalcemia is a major metabolic issue in babies. It is characterized as total serum calcium concentration less than or equivalent to 7.5 mg/dl. It happens in normally newborn children, prematures, babies of diabetic moms, after “perinatal asphyxia” or “intrauterine development restriction and low calcium intake.

Aim of study: to evaluate the effect of phototherapy on serum calcium in neonates with indirect hyperbilirubinemia.

Methods: A cross sectional study was achieved. Assessment of neonates clinically with details history and physical examination was carried out. Gestational age was assessed, duration of phototherapy was recorded. Serum bilirubin and calcium were checked up on admission, and after 24 hours from starting phototherapy.

Result: In this study, forty neonates with jaundice were enrolled with mean gestational age of (37.1 weeks); 30% of them had preterm gestational age and 70% of them had term gestational age. Male jaundiced neonates were more than females (55% vs. 45%). Breast-feeding was present for 5% of jaundiced neonates, while 50% of them were on formula feeding and 45% of neonates were on mixed feeding. Mean serum calcium before phototherapy of jaundiced neonates was (8.9 mg/dl), while mean serum calcium 24 hours after phototherapy of jaundiced neonates was (8.6 mg/dl). The mean serum calcium of jaundiced neonates was not significantly different before and 24 hrs after phototherapy (p=0.17) .The mean serum calcium of jaundiced neonates was not significantly different before and 24 hrs after ordinary phototherapy (p=0.7). The mean serum calcium of jaundiced neonates was not significantly different before and 24 hrs after extensive phototherapy (p=0.17).

Conclusion: There is no association between phototherapy and neonatal hypocalcemia.