Hypocalcaemia- The detrimental effect of phototherapy.

Abstract

Background: Jaundice is the single most common abnormal physical finding in the first week of life. Jaundice is observed during the 1^st week of life in approximately 60% of term infants and 80% of preterm infants. The most common used methods of treating hyperbilirubinemia are phototherapy, exchange transfusion and pharmacological therapy. Potential but lesser known complication of phototherapy is hypocalcaemia. Our objective is to study the effect of phototherapy used for the management of   hyperbilirubinemia and   its   consequent effect on calcium homeostasis.

Methodology: This study was conducted on total 180 neonates admitted to Neonatal intensive care unit of a tertiary care center of ‘Steel city of Central India’. All study participants are included in two groups. One group included   45 preterm neonates (gestational   age >32 week but <37 week) and  other group included  45  full term neonates (gestational   age >37 week). In   addition, 45 neonates served   in   each   group as control. All had hyperbilirubinemia. The controls were fully matched with the study group. All the neonates included in the study group required management with phototherapy. The neonates in the control group were managed without phototherapy. Total Serum bilirubin levels and serum calcium levels were checked before and after phototherapy.

Result: The mean total serum calcium showed a statistically significant fall after exposure to phototherapy in the study group. The commonest complication observed after phototherapy was loose stools and rashes in preterm and full term neonates.

Conclusion: In neonates with hyperbilirubinemia serum calcium level significantly decreases due to phototherapy. Preterm new-borns suffer more from hypocalcaemia than full term new-borns after receiving phototherapy.