Effect of phototherapy on pro-oxidant/antioxidant balance in newborns with Jaundice

Abstract

Introduction: Jaundice is the most common condition requiring medical attention in newborns. Phototherapy is the standard treatment for jaundice. However, in recent decades, phototherapy has been considered as an oxidative stress that can cause lipid peroxidation and damage to DNA. Accordingly, the present study was conducted to examine the possible effects of phototherapy on the Pro-oxidant/Antioxidant Balance (PAB) in jaundiced newborns.
 Methods: The present clinical trial was conducted on 70 icteric term neonates admitted to Ghaem Hospital of Mashhad, Iran between February 2013 and February 2015. The study population consisted of all term neonates who were admitted to the hospital within 2 to 14 days after birth for unconjugated hyperbilirubinemia (bilirubin levels > 15 mg/dl) and were treated with phototherapy. Neonates’ and mothers’ characteristics, along with the cause of jaundice, were collected through a researcher-made questionnaire, and neonates’ bilirubin levels and PAB values were simultaneously checked before, during and after the phototherapy. Finally, bilirubin levels and PAB values were compared using statistical methods.
 Results: According to the results, neonates’ underlying characteristics were not statistically different. The average and standard deviation of bilirubin levels and PAB values were, respectively, 18.90±2.97 and 16.29±9.83 (before phototherapy), 15.71±3.16 and 29.63±12.56 (during phototherapy), and 12.37 ±3.57 and 40.91 ±13.35 (after phototherapy).
 Conclusion: The results of this study demonstrate that decreased levels of bilirubin after phototherapy cause a shift in the PAB value in favor of oxidants.

The Comparison of Pro-Oxidant-Antioxidant Balance in Physiologic and Pathologic Jaundice

“…Furthermore, another study by the same author suggested that phototherapy can cause peroxidation of lipids and damage to DNA (11). In confirmation of the previous study, another research demonstrated that as an infant's bilirubin level decreases with phototherapy the balance of oxidant-antioxidant is disrupted toward antioxidant depletion (9). Results of the other investigation likewise showed that blood exchange causes an oxidantantioxidant imbalance in favor of the oxidants (12).…”

“…On the other hand, treatment of physiologic jaundice is not risk-free, therefore overtreatment must be done with caution (9). The most common and effective treatment for jaundice is phototherapy which is known to be a safe and tolerable method in infants (10).…”

Comparing maternal and neonatal prooxidant-antioxidant balance during delivery

“…The findings of a study comparing PAB levels in neonates with and without asphyxia indicated mean PAB levels were 20 and 40 HK in healthy neonates and neonates with asphyxia, respectively ( 5 ). In two other studies, the mean PAB of neonates was reported to be about 40 HK after jaundice recovery ( 25 , 26 ). A study investigated the effects of selenium consumption, critical to the function of some anti-oxidant enzymes, during pregnancy on the PAB levels of neonates.…”

Características e efeitos da fototerapia em recém-nascidos: revisão integrativa

“…Em relação ao estresse oxidativo, os estudos trazem evidências que afirmam que tanto a fototerapia convencional quanto a fototerapia de LED aumentam o índice de estresse oxidativo (OSI), assim como do estresse oxidativo total (TOS) tanto em recém-nascidos ictéricos a termo e prematuros quanto em recém-nascidos com hiperbilirrubinemia hemolítica (Mokhtar, et al, 2019), também corroborando para que a capacidade antioxidante total (TAC) diminuísse a nível sérico em todos os estudos, com maior significância nos recém-nascidos sob fototerapia convencional (Kale, et al, 2013;Boskabadi, et al;2018;Mokhtar, et al, 2019). Foi achada relação significativa entre o TOS sérico aumentado e a fototerapia convencional com luzes fluorescentes azuis e a fototerapia intensiva por LED, porém a fototerapia por LED com almofada de fibra óptica não possuiu significância no aumento do TOS (Kale, et al, 2013).…”