Study of changes in serum sodium and potassium levels in term and preterm neonates following phototherapy


  • Likitha Annachira Chinnappa Department of Pediatrics, Mysore Medical College and Research Institute, Mysore, Karnataka, India
  • Sudha Rudrappa Department of Pediatrics, Mysore Medical College and Research Institute, Mysore, Karnataka, India



Electrolyte changes, Neonatal hyperbilirubinemia, Phototherapy


Background: Neonatal hyperbilirubinemia is a common physical finding in the first week of life. It is a common cause of hospital readmission during neonatal period. Phototherapy is an important treatment modality. However, it has some complications; amongst them serum electrolyte changes are a common complication. Objective of this study is to determine the changes in serum sodium and potassium in neonates before and after phototherapy and compare the occurrence of these changes in relation to gestational age and birth weight.

Methods: In a prospective hospital based comparative study both term and preterm neonates admitted in neonatal intensive care unit receiving phototherapy at Cheluvamba hospital Mysore from July 2021 to April 2022 (10 months) were studied. A predesigned proforma aided the enrolment of new-borns into the study. Serum bilirubin and electrolytes and a comparative study was made between before and after phototherapy groups to determine the incidence of electrolyte imbalance.

Results: The study group included 100 neonates. Incidence of low-birth-weight babies was 28% and preterm 22%. Mean birth weight and gestational age was 2.91±0.65 kg and 38.43±1.96 week respectively. The incidence of hyponatremia post phototherapy was found to be 9% which was more in low birth weight and preterm neonates (p<0.001) and was statistically significant. The incidence of potassium changes was found to be non-significant.

Conclusions: The study shows that neonates under phototherapy are at higher risk of hyponatremia. This risk is greater in premature and low birth weight babies and hence this group of babies should be closely monitored for electrolyte changes and managed accordingly.


Martin RJ, Fanaroff AA, Walsh MC. Fanaroff and Martin’s neonatal-perinatal medicine: Diseases of the fetus and infant. 11th ed. Philadelphia: Elsevier/Saunders; 2019;1788-96.

Maisels MJ. Jaundice. In: Avery GB, Fletcher MA, MacDonald MG, eds. Neonatology: pathophysiology and management of the newborn. 6th ed. Philadelphia: Lippincott Williams and Wilkins; 2005;765-820.

Maisels MJ, Kring E. Length of stay, jaundice, and hospital readmission. Pediatrics. 1998;101:995-8.

Narayana S, Aggarwal M, Upadhyay A, Deorari AK, Sindh M, Paul VK. Survival and morbidity in extremely low birth weight (ELBW) infants. Indian Pediatr. 2003;40(2):130.

Das S, Landeghem FKH. Clinicopathological spectrum of bilitubin encephalopathy/kernicterus. Diagnostics. 2019;9:24.

Slusher TM, Zamora TG, Appiah D, Stanke JU, Strand MA, Lee BW, et al. Burden of severe neonatal jaundice: A systematic review and meta-analysis. Br Med J Paediatr. 2017;1:e000105.

Dutta S. Phototherapy for neonatal jaundice recent advances and controversies. J Neonatal. 2001;1(1):39-44.

Karamifar H, Pishva N, Amirhakimi GH. Prevalence of phototherapy induced hypocalcemia. Iran J Med Sci. 2002;27(4):166-8.

Gozetici MA, Yigit AK. Effect of phototherapy on serum electrolyte levels. Cerrahpasa Med J. 2018;45(1):16-20.

Rani MR, Santhalakshmi M, Saravanan L. Study on serum electrolyte changes in neonates receiving phototherapy for unconjugated hyperbilirubinemia. Indian J Clin Anat Physiol. 2018;5(1):22-55.

Reddy AT, Bai KV, Shankar SU. Electrolyte changes following phototherapy in neonatal hyperbilirube-nemia. Int J Sci Res. 2015;4(7):231-7.

Ghosh UK, Parvin R, Sultana A. Electrolyte changes following phototherapy in neonatal hyperbilirubi-nemia. Jahurul Islam Med J. 2020;15(1):130-5.

Curtis MD, Guandalini S, Fasano A, Ciccimarra F. Diarrhoea in jaundiced neonates treated with phototherapy: role of intestinal secretion. Arch Dis Child. 1989;64:1161-4.

Beresford D, Conolly G. Fluid and electrolyte balance. In: Neonatal intensive nursing care. 3rd ed. Washington DC: Routledge Taylor and Francis Group; 2015:258.






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