A study on effect of phototherapy on platelet count in neonates with neonatal hyperbilirubinemia in a tertiary care rural hospital
Keywords:Phototherapy, Unconjugated Hyperbilirubinemia, Platelet count
Background: Phototherapy is one of the most common and invasive methods in treatment of unconjugated hyperbilirubinemia of the neonate. Adverse effects of phototherapy include loose stools, skin rash and dehydration. There are very few studies which show the effect of phototherapy on platelet count. So, this study was done to show the effect of phototherapy on platelet count.
Methods: This is a prospective hospital based comparative study on 100 eligible neonates admitted in the Neonatal Intensive Care Unit receiving phototherapy at Adichunchanagiri Institute of Medical Sciences and research hospital, a rural tertiary care hospital, B. G. Nagara, Nagamangala Taluk, Karnataka from December 1st 2013- November 30th 2014. Two samples were taken before and after phototherapy, were taken and analysis was done. The results were analysed statistically.
Results: A total of 100 neonates were included in our study of which 55(55%) were males and 45(45%) were females. The mean (+/-SD) platelet counts were 2.23+/-0.28 lak before phototherapy and 1.82+/-0.01 lak after phototherapy. There was a decline in the mean platelet count after phototherapy but it was not statistically significant (p=0.150). However there was a significant decline in mean platelet count in LBW babies.
Conclusions: In our study there was a decline in mean platelet count after phototherapy but it was not statistically significant except for LBW babies. The treating Doctor should keep other causes of thrombocytopenia when the patient is receiving phototherapy.
Singh M. Care of the Newborn. 7th ed. New Delhi: Sagar Publications. 2010:254-74.
Maisels MJ. Jaundice. In: Avery GB, Fletcher MA, MacDonald MG (eds). Neonatology: Pathophysiology and Management of the Newborn. 5th ed. Lippincott Williams and Wilkins: Philadelphia. 1999:765-820.
Maisels MJ, Kring E. Length of stay, jaundice, and hospital readmission. Pediatrics. 1998;101:995-8.
Gregory MLP, Martin CR, Cloherty JP. Neonatal Hyperbilirubinemia. In: Cloherty JP, Eichenwald EC, Hansen AR, Stark AR (eds.) Manual of neonatal care. 7th ed. Philadelphia: Lippincott Willams and Wilkins. 2012:304-339.
Narayana S, Aggarwal, Upadhyay A, Deorari AK, Sindh M, Paul VK. Survival and morbidity in Extremely Low Birth Weight (ELBW) infants. Indian Pediatrics. 2003;40(2):130-5.
Maisels MJ, Newman TB. Kernicterus in otherwise healthy, breast-fed term newborns. Pediatrics. 1995;96(4):730-3.
Dutta S. Phototherapy for neonatal jaundice - recent advances and controversies. Journal of Neonatalogy. 2001;1(1):39-44.
Maurer HM, Fratkin M, McWilliams NB. Effects of phototherapy on platelet counts in Low Birth weight infants and on platelet production and life span in Rabbits. American Academy of Pediatrics Article, 1976.
Pishva N, Pishva H. Incidence of thrombocytopenia in hyperbilirubinemic neonates during phototherapy. Acta Medica Iranica. 2000;38(1):7-9.
Sanjeev MK, Col Rakesh G. Incidence of thrombocytopenia following phototherapy in hyperbilirubinemic neonates. MJAFI. 2011;67(4):329-32.
Modanlou HD, Oritz O, Wu PK. Lack of thrombocytopenia in newborn infants treated with phototherapy. Pediatric Research. 1977;11:538.
Sakha K, Sultani H. Effect of phototherapy on platelet and white blood cell count in term infants. Med J of Tabriz University of Medical Sciences. 2006;28(3):14-8.
Monsef A, Eghbalian F. Does conventional phototherapy have any effect on platelet count in full term neonates with indirect hyperbilirubinemia. Sci Res. 2011;3(12):709-11.
Ahmadpour KM, Zahedpasha Y, Taghavi M, Bijani A. Effect of phototherapy on platelet, reticulocyte and white blood cells in full term neonates with hyperbilirubinemia. Med J of Mashhad University of Medical Sciences. Wnter. 2013;55(4):211-7.