Comparison of Two Phototherapy Methods (Prophylactic vs Therapeutic) for Management of Hyperbilirubinemia in Very Low Birth Weight Newborns

Seyedeh-Sarah Nazem-Sadati; Majid Mohammadizadeh; Ramin Iranpour

IJ Pediatrics

The Scientific Journal of Growth & Development Research Center

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Comparison of Two Phototherapy Methods (Prophylactic vs Therapeutic) for Management of Hyperbilirubinemia in Very Low Birth Weight Newborns

Author(s):

Seyedeh-Sarah Nazem-Sadati¹,

Majid Mohammadizadeh¹,

Ramin Iranpour^1,*

1Department of Pediatrics, and Child Health Promotion Research Center, Isfahan University of Medical Sciences, Iran

IJ Pediatrics:Vol. 21, issue 4; 425-430

Published online:Dec 31, 2011

Article type:Research Article

Received:Jun 22, 2010

Accepted:Feb 06, 2011

How to Cite:Seyedeh-Sarah Nazem-SadatiMajid Mohammadizadeh Ramin IranpourComparison of Two Phototherapy Methods (Prophylactic vs Therapeutic) for Management of Hyperbilirubinemia in Very Low Birth Weight Newborns.Iran J Pediatr.21(4):425-430.

Abstract

Objective: Preterm and low birth weight (LBW) infants are at greater risk of developing bilirubin-associated brain damage compared with term infants. Certainly, phototherapy, if used appropriately, is capable of controlling the bilirubin levels in LBW infants; but there is not a unique phototherapy treatment strategy in LBW infants. This study was designed to compare the prophylactic phototherapy and late treatment of jaundiced newborns weighing 1000-1500 grams.
Methods: Sixty newborns with birth weight 1000–1500 g were studied. They were divided into two groups: the "Prophylactic" group, in which phototherapy started within six hours after birth and continued for at least 96 hours, and the "Treatment" group, which received phototherapy when indicated according to birth weight and suspended when bilirubin level fell below 50% of bilirubin level for blood exchange. Mean value of daily transcutaneous bilirubin (TCB), duration of phototherapy, the need for blood exchange, and the highest TCB value in both groups were analyzed.
Findings: In the prophylactic group, the highest daily mean rate of TCB was 7.71±1.84 mg/dl, which happened on the third day. In the treatment group, it was 8.74±1.72 mg/dl on the fourth day after birth. The TCB values in prophylactic group were significantly less than those of the treatment group only on the fourth and fifth days after birth (P<0.001). Although the median duration of phototherapy in the treatment group was shorter than that of the prophylactic group (137.60±57.39 vs 168.71±88.01 hours, respectively), this difference was not statistically significant. Only one neonate needed blood exchange in the treatment group.
Conclusion: The prophylactic phototherapy treatment for babies weighing 1000–1500 g significantly decreases bilirubin levels on the fourth and fifth days after birth but the clinical course of hyperbilirubinemia does not alter in LBW infant, as indicated by the non-significant change in the duration of phototherapy.

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