Role of phenobarbitone in prophylaxis of neonatal jaundice in babies with birth weight 1250-2400 grams
DOI:
https://doi.org/10.18203/2349-3291.ijcp20150780Keywords:
Jaundice, Serum bilirubin level, Phototherapy, Exchange transfusion, Low birth weightAbstract
Background: This study was performed to study the role of prophylactic phenobarbitone in preventing neonatal jaundice in babies with birth weight 1250 to 2400 gm and to study the incidence of neonatal jaundice, need for phototherapy and exchange transfusion in babies inspite of giving prophylactic phenobarbitone.
Methods: The babies were randomized into 2 groups. Group I babies were given 10 mg/Kg loading dose of phenobarbitone within 6 hrs of life followed by maintenance dose of 5 mg/Kg/day intravenous from day 2 to day 5. Group II babies were taken as controls, ensuring that both the group babies weighed between 1250gms to 2400gms. For those babies in Group I and Group II, who developed Jaundice up to chest wall and beyond clinically(significant level according to birth weight) by observing in day light, serum bilirubin level was measured. Depending on Serum bilirubin levels, according to birth weight, Phototherapy, Exchange Transfusion was opted.
Results: Among group I, out of 51 babies, 8 babies (15.68%) required phototherapy,5 babies (62.5%) required for 2 days and 3 babies (37.5%) required for 3 days,, whereas among group II, out of 53 babies, 24 babies (45.28%) required phototherapy, 13 babies (54.16%%) required for 2 days and 11 babies (45.83%) required for 3 days. Among group I, none of the babies (0%) required Exchange Transfusion whereas among group II, 4 babies (7.54%) required Exchange transfusion.
Conclusions: Incidence of jaundice was 100% among both the groups, No of babies who developed significant jaundice were low in Group I, day of appearance of significant level of jaundice was delayed in Group I, mean age of onset of significant level of jaundice was delayed in preterm babies compared to term babies, need for phototherapy and exchange transfusion were low in Group I.
References
National Neonatology Forum (NNF). National Neonatal, Preinatal Database, New Delhi 2002-2003.
Narang A, Kumar P, Kumar R. Neonatal jaundice in very low birth weight babies. Indian J Pediatr. 2001;68:307-9.
Avery’s Diseases of Newborn 8th edition 79: 1226-56.
Pearlman PC, Lee RT. Clinic chem. 1974;20:447.
Epstein F, Kuban K, Skoutelli H, Melizer K, Brown E, Krishnamurthy KS, et al: Reduced incidence of hyperbilirubinemia in low birth-weight babies receiving phenobarbitone. Pediatr Res. 1985;19:340A.
Valdivieso J, Anwar M, Hiatt M. The course of hyperbilirubinemia in VLBW infant treated with Phenobarbitone. Pediatrics 1985:19180.
Kumar R, Narang A, Kumar P, Gareval N. Phenobarbitone prophylaxis for neonatal - jaundice in babies with birth weight 1000-1499 gms. Indian Pediatrics. 2002;39:945-51.
Chawla D. Indian Pediatr. 2010;47(5):401-7.