A Meta-Analysis of the Oxidative and Inflammatory Reactions to the Type and Duration of Phototherapy in Neonates With Jaundice.

Abstract

Background: Phototherapy reduces serum free bilirubin levels but can also cause various short- and long-term side effects. This meta-analysis examined the potential relationship between phototherapy duration and type, as well as oxidative and inflammatory reactions in newborns with hyperbilirubinemia.

Methods: We searched PubMed, the Cochrane Library, Web of Science, and Embase for observational studies published before December 31, 2023. The Quality in Prognostic Studies (QUIPS) tool was used to evaluate the risk of bias. The intervention included the durations (1.5, 12, 24, 36, 48, 72, and > 90 h) and types (light-emitting diode (LED), conventional, and intensive) of phototherapy.

Results: A total of 24 observational studies with 1230 newborns were included in the study. Phototherapy increased the increased oxidative stability index. The oxidative indexes decreased after 1.5 or 90 h of phototherapy but increased after 24 or 48 h. Phototherapy increased nitric oxide levels but was associated with reduced total antioxidant capacity and glutathione. Conventional phototherapy reduced antioxidant indices, whereas LED was associated with increased oxidative indices. After 36 h, phototherapy reduced hematocrit levels. Phototherapy increased the secretion of inflammatory mediators by peripheral blood mononuclear cells after 24 h. In addition, conventional phototherapy increased levels of inflammatory mediators in the serum of infants after 72 h.

Conclusion: Side effects of phototherapy, such as altered oxidant/antioxidant status and inflammatory reactions, may vary depending on the type of phototherapy used. However, no clear pattern was observed in the alterations in these oxidative/inflammatory markers as a function of the duration of phototherapy.