The effect of phototherapy on serum calcium level in neonates with hyperbilirubinemia: a cross sectional study

Authors

  • Anjali Vasant Kale Department of Pediatrics, Mahatma Gandhi Institute of Medical Sciences, Aurangabad, Maharashtra, India
  • Pranoti Uttam Jadhao Department of Pediatrics, Mahatma Gandhi Institute of Medical Sciences, Aurangabad, Maharashtra, India
  • Aashna Valecha Department of Pediatrics, Mahatma Gandhi Institute of Medical Sciences, Aurangabad, Maharashtra, India
  • Sreelekha Kethepalli Department of Pediatrics, Mahatma Gandhi Institute of Medical Sciences, Aurangabad, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20203174

Keywords:

Hypocalcemia, Neonatal hyperbilirubinemia, Phototherapy

Abstract

Background: Neonatal Hyperbilirubinemia is one of the leading causes for admission in NICU in the first week of life. This condition if left untreated may lead to irreversible neurological damage hence increasing mortality and morbidity in newborns. Neonatal Hyperbilirubinemia is treated with phototherapy which employs blue wavelengths of light to change unconjugated bilirubin in the skin. The bilirubin is then converted to less toxic water-soluble photo-isomers that are excreted in the bile and urine. There are several toxic effects to the use of this treatment, one of them being hypocalcemia.

Methods: This study has been done at Mahatma Gandhi Institute of Medical Sciences in 2016-2018 on 100 new-borns to prove the effect of phototherapy on serum calcium levels in neonates with hyperbilirubinemia. New-born who were admitted in NICU for Hyperbilirubinemia were screened according to inclusion and exclusion criteria, their sample for serum calcium and serum bilirubin levels were taken as pre and post phototherapy samples.

Results: It was observed that the mean Serum calcium level before phototherapy in neonates was 9.31 mg/dl with standard deviation of 0.69 mg/dl. Whereas after phototherapy mean serum calcium level in neonates was 8.88 mg/dl with standard deviation of 0.73 mg/dl. There was statistically significant mean difference in serum calcium level at before and after phototherapy in neonates (p<0.0001).

Conclusions: This study proves the hypothesis that phototherapy can cause hypocalcemia in neonates with hyperbilirubinemia.

References

Singh M. Care of the Newborn. 7th edn. New Delhi: Sagar Publications; 2010:254-274.

Young Infants Clinical Signs Study Group. Clinical signs that predict severe illness in children under age 2 months: a multicentre study. Lancet. 2008;371:135-42.

Fanaroff A, Wlash M. Neonatal-Perinatal Medicine, Diseases of the Fetus and Infant, 9th Edn, Elsevier Mosby; 2010:1443-1481.

Maisels MJ, Kring EA. Length of Stay, Jaundice and Hospital Readmission. Pediatrics. 1998;101:995-8.

Gregory MLP, Martin CR, Cloherty JP. Neonatal Hyperbilirubinemia. In: Manual of neonatal care.7th edn. Philadelphia: Lippincott Willams and Wilkins; 2012:304-339.

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

American Academy of Pediatrics Practice Parameter. Management of hyperbiliru-binemia in the healthy term newborn. Pediatrics. 1994;94:558-65.

Young Infants Clinical Signs Study Group. Clinical signs that predict severe illness in children under age 2 months: a multicentre study. Lancet. 2008;371(9607):135-42.

Yadav RK, Sethi RS, Sethi AS, Kumar L, Chaurasia OS. The Evaluation of Effect of Phototherapy on Serum Calcium Level. People’s J Sci Res. 2012;5(2):1-4.

Rozario CI, Pillai PS, Ranamol T. Effect of phototherapy on serum calcium level in term newborns. Int J Contemp Pediatr. 2017;4:1975-9.

Bahbah MH, ElNemr FM, ElZayat RS, Aziz EA. Effect of phototherapy on serum calcium level in neonatal jaundice. Menoufia Med J. 2015 Apr 1;28(2):426-30.

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.

Durga T, Ravi Kumar RM. The Effect of Phototherapy on serum ionized calcium levels in neonates with unconjugated hyper bilirubinemia. J Evid Med Healthcare. 2015;2(17):2596-601.

Goyal S, Srivastava A, Bhattacharjee P, Goyal I, Malhotra K. Effect of phototherapy on serum calcium levels in neonates receiving phototherapy for neonatal jaundice. Int J Res Med Sci. 2018;6:1992-5.

Goyal S, Srivastava A, Bhattacharjee P, Goyal I, Malhotra K. Effect of phototherapy on serum calcium levels in neonates receiving phototherapy for neonatal jaundice. Int J Res Med Sci. 2018;6:1992-5.

Singh PK, Chaudhuri PK, Chaudhary AK. Phototherapy Induced Hypocalcemia in Neonatal. Hyperbilirubinemia. 2017;16(4):35-8.

Al-Ali MA, Sawma AI, Alshrari NM, Rizk MM, Salama GS. Phototherapy Induced Hypocalcemia, a Jordanian and Saudi Experince. Int J Sci Eng Res. 2017;8(11):578-81.

Gupta A, Gupta P, Ali S, Gupta S. Effect of mode of delivery: normal, induced and caesarean section on neonatal serum bilirubin. Indian J Clin Anato Physiol. 2016;3(3):269-72.

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Published

2020-07-22

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Original Research Articles