Extensive Versus Traditional Phototherapy in Treatment of Neonatal Jaundice


ABSTRACT:BACKGROUND:Neonatal jaundice affects more than 60% of neonates. Phototherapy is the main treatment, and its effectiveness is directly related to the duration of exposure, exposed surface area of the infant, and intensity of light used for phototherapy.OBJECTIVE:To determine the role of extensive phototherapy in the treatment of neonatal jaundice and to compare efficacy of extensive phototherapy with traditional phototherapy.PATIENTS AND METHODS:Over a period of one month occupying throughout April 2017, 100 cases of neonatal jaundice whom either term or preterm, near term (≥ 35 weeks of gestational age), visited Al-Elwiya Pediatrics Teaching Hospital were collected from day zero age, precisely from 1st hour till 240 hours of age. Half of them were put on traditional phototherapy and other half were on extensive phototherapy depending on clinical grounds and their total serum bilirubin levels according to American Academy of Pediatrics guidelines, where a cutline total serum bilirubin (TSB) level of 20-25 mg/ dl was used to identify a phototherapy type.RESULTS:Percentage of improvement in neonates whose treatment included extensive (intensive) phototherapy was 72% compared to 40% for traditional phototherapy, with full term neonates` relative risk (1.9) was higher than preterm (near term babies) (1.7), also males` relative risk (1.84) was higher than females` (1.78), but no significant difference was seen regarding both (gestational age and sex). Breast fed, bottle fed, and mixed fed newborns were improved better in extensive than traditional phototherapy (87.50% vs 41.20%, 55% vs 36.36%, 78.57% vs 45.45%, respectively). Extensive phototherapy was more frequently associated with lethargy as a side effect (12% vs 10%).CONCLUSION:Extensive phototherapy was more effective in treating neonatal hyperbilirubinemia (significant p value= 0.0012), but with a slightly higher percentage of lethargy as a side effect (12% vs 10%).KEY WORDS: neonatal jaundice, traditional phototherapy, extensive phototherapy.