Effect of phototherapy on serum calcium level in term newborns

Cyril Ignatious Rozario, Preethi S. Pillai, Ranamol T.


Background: Hyperbilirubinemia is one of the most prevalent problems in neonates. Jaundice is observed during first week of life in approximately 60% of term neonates and 80 % of preterm neonates. Phototherapy is one of the routine methods for management of hyperbilirubinemia. The aim of this study is to assess the effect of phototherapy on serum calcium level in term newborns with neonatal hyperbilirubinemia who undergo phototherapy and to find out the association between effect of phototherapy on serum calcium level and birth weight, postnatalage, type of feeding and blood group incompatibility.

Methods: 100 newborns with neonatal hyperbilirubinemia admitted in newborn nursery were selected for the study. Serum calcium estimation was done before phototherapy. All newborns were subjected to double surface phototherapy. After 48 hours of phototherapy serum calcium was estimated and compared with earlier value.

Results: Out of 100 newborns studied 67 babies had a decrease in serum calcium level after 48 hrs of phototherapy. And this reduction in calcium level was found to be statistically significant (p value <0.001). Only 3 babies developed hypocalcemia (serum calcium <7 mg/dl). None of them were symptomatic. There was no significant association between reduction in serum calcium level and birth weight, postnatalage, type of feeding and blood group incompatability.

Conclusions: There is signiticant reduction in serum calcium level after phototherapy but risk of hypocalcemia is low in healthy full-term neonates. No significant association was found between reduction in serum calcium level and birth weight, postnatal age,type of feed, and blood group incompatibility.


Hyperbilirubinemia, Hypocalcemia, Newborns, Phototherapy

Full Text:



Anthony J, Piazza, Stoll BJ. Jaundice and hyperbilirubinemia in newborn. In: Kliegman, Behrman, Jenson, Stanton (eds) Nelson Text book of pediatrics. 18th ed. Philadephia:Saunders;2008:756-57.

Sethi H, Saili A, Dutta AK. Phototherapy induced hypocalcemia. Indian Pediatr. 1993;30(12):1403-6.

Vrman HJ, Wong RJ, Stevenson DK, Route RK, Reader SD, Fejer MM. Light-emitting diodes: a novel light source for phototherapy. Pediatr Res. 1998 Nov;44(5):804-9.

Xiong T, Qu Y, Cambier S, Mu D. The side effects of phototherapy for neonatal jaundice: what do we know? What should we do?. Eur J Pediatr. 2011 Oct 1;170(10):1247-55.

Singh M. Jaundice in newborn. In: Meharban Singh(ed) Care of the newborn. 6th ed. 2004:253-5

Camilla R, Martin, Cloherty JP. Neonatal hyperbilirubinemia. In: John P. Cloherty, Eri C Eichenward, Ann R Stark(eds) Manual of neonatal care. 6th edition, Philadephia:Lippincott Williams and Wilkins;2008:201.

Maisels MJ. Jaundice. In: Avery’s Neonatology Pathophysiology and management of the Newborn. McDonald MG, Mullet MD, Seshia MMK 6th Ed. Lippincott Williams & Wilkins;2005:768-846.

Romagnoli C, Polidori G, Cataldi L, Tortorolo G, Segni G. Phototherapy- induced hypocalcemia. J Pediatr. 1979 May;94(5):815-6.

Hakanson D, Penny R, Bergstrom WH. Calcemic responses to photic and pharmacologic manipulation of serum melatonin. Pediatr Res. 1987;22(4):414-6.

Hunter KM. Hypocalcemia. In: Cloherty JP, Eichenwald CE, Stark AR, editors. Manual of Neonatal Care. 5th ed. Philadelphia: Lippincott Wiliams and Wilkins;2004:579-88.

Kim SH, Park JH. Effect of phototherapy on bone metabolism in newborn rats. J Korean Soc Neonatal. 2001;8(2):206-10.

Yadav R, Sethi RS, Sethi AS, Kumar L, Shankar Chauraisa O. The evaluation of effect of phototherapy on serum calcium level. PJSR. 2012;5(2):1-4.

Alizadeh-Taheri P, Sajjadian N, Eivazzadeh B. Prevalence of phototherapy induced hypocalcemia in term neonate. Iran J Pediatr. 2013;23(6):710-11.

Karamifar H, Pishva N, Amirhakimi GH. Prevalence of phototherapy induced hypocalcemia. IJMS. 2002.27(4):166-8.

Eghbalian F, Monsef A. phototherapy induce hypocalcemia in icteric newborn. Iran J Med Sci. 2002;27(4):169-71.

Arora S, Narang GS, Singh G. Serum calcium levels in preterm and term neonates on phototherapy. J Nepal Pediatr Soc. 2014;34:24-32.

Medhat FB. Assessment of phototherapy induced hypocalcaemia. Thesis submitted for M.Sc. Pediatricsin Cairo University. Classification no. 8461;2006.

Manoj GM, Deka A. Comparative study of incidence of phototherapy induced hypocalcemia in preterm v/s term neonates. IJSR. 2016;5(7):341-4.