Effects Of Phototherapy On Serum Calcium Level In Neonates With Hyperbilirubinemia

Q. Javaid, Salma Aziz, Noor-ul-Ain, Uzma Abid, Ayesha Afzal, Umer Javaid
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Abstract

Objective: To study the frequency of hypocalcemia in neonates receiving phototherapy with indirect hyperbilirubinemia Materials and Methods: Descriptive case series study was conducted from September 5, 2018, to March 5, 2019, in the NICU of the Paediatric Department Benazir Bhutto Hospital, Rawalpindi. Approval was sought from the hospital’s ethical committee. Neonates fulfilling inclusion criteria were enrolled in the study after obtaining informed consent from the parents. Before giving phototherapy, serum calcium levels were checked. Phototherapy was given for 48 hours. Serum calcium levels were reassessed after 48 hours of phototherapy. Data was entered on a structured proforma and statistical analysis of data was performed. Results: Out of 150 patients enrolled in the study 83(55.33%) were male and 67(44.67%) were female. The mean age of patients was 52.52 hours with minimum and maximum ages of 26 hours and 80 hours. The mean Indirect serum bilirubin level was 15.59 ± 2.36. A total of 50(33.33%) cases had hypocalcemia after 48 hours of phototherapy, all of these neonates had normal calcium levels before phototherapy. When hypocalcaemia was stratified for gestational age, birth weight and serum bilirubin levels at baseline, there was no significant difference in the frequency of hypocalcaemia concerning these effect modifiers. Conclusion: It is concluded that the frequency of hypocalcemia is higher in neonates with indirect hyperbilirubinemia after receiving phototherapy. One needs to be vigilant in dealing with neonates in this context, while serial measurements of calcium levels and monitoring for complications of hypocalcaemia should be included in every institution’s policy
光疗对高胆红素血症新生儿血清钙水平的影响
目的:研究间接高胆红素血症接受光疗的新生儿低钙血症发生率。资料和方法:于2018年9月5日至2019年3月5日在拉瓦尔品第贝娜齐尔·布托医院儿科NICU进行描述性病例系列研究。得到了医院伦理委员会的批准。在获得父母的知情同意后,符合纳入标准的新生儿被纳入研究。在给予光疗前,检查血清钙水平。光疗48小时。光疗48小时后重新评估血清钙水平。数据以结构化形式输入,并对数据进行统计分析。结果:纳入研究的150例患者中,男性83例(55.33%),女性67例(44.67%)。患者平均年龄为52.52小时,最小年龄为26小时,最大年龄为80小时。平均间接血清胆红素水平为15.59±2.36。50例(33.33%)光照后48小时出现低钙血症,光照前钙水平均正常。当根据胎龄、出生体重和基线时的血清胆红素水平对低钙血症进行分层时,这些效应调节因子在低钙血症发生率方面没有显著差异。结论:间接性高胆红素血症新生儿接受光疗后低血钙发生率较高。在处理这种情况下的新生儿时需要保持警惕,而钙水平的连续测量和低钙血症并发症的监测应包括在每个机构的政策中
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