Neonatal Phototherapy and Clinical Characteristics: The Danish National Patient Registry 2000–2016

Abstract

Purpose Phototherapy is the standard treatment for neonatal hyperbilirubinemia. It is important to collect data on phototherapy to support research related to the efficacy and safety of phototherapy. We explored the registration of phototherapy in the Danish National Patient Registry (DNPR) and the clinical characteristics of neonates treated with phototherapy. Methods We identified children born alive in Denmark from 1 January 2000 through 30 November 2016 from the DNPR (N=1,044,502). We calculated the proportion of children registered that received phototherapy during the neonatal period and examined temporal trends, both nationwide and at the level of individual hospitals. In a sub-cohort of children born at Aarhus University Hospital (AUH) in 2002–2016 (N=71,781), we analyzed the proportions of children registered that received phototherapy, according to sex, gestational age, birth weight, and neonatal characteristics, like Apgar score, birth asphyxia, and infections. Results We identified 11,295 (1.1%) registered that received phototherapy. The proportions of children registered that received phototherapy differed among hospitals (range: 0 to 4.1%). Nationwide registration was low during the study period, but it increased to 1.8% in 2016. For the AUH sub-cohort the proportion of children registered with phototherapy averaged 4.4% (N=3182, range:3.9–5.1%). The proportion of children registered with phototherapy was inversely correlated with gestational age and birth weight, and positively correlated with neonatal characteristics, including low Apgar score, birth asphyxia, and infections. Conclusion Phototherapy was under-reported in the DNPR and the proportions of children registered that received phototherapy differed among hospitals. The non-compulsory policy for reporting treatment and care in hospitals to the DNPR might explain the variation. The most consistent reporting was observed among children born in an university hospital, where 4.4% of children registered that received phototherapy, and phototherapy was inversely associated with gestational age, birth weight, and positively associated with clinical characteristics like birth asphyxia, and infections.

Clinical Applications of Phototherapy in Treating Skin Disorders

“…In neonatology, it is used to treat hyperbilirubinemia in newborns, and in psychiatry, light therapy is effective in treating seasonal affective disorder (SAD). In addition, phototherapy has the potential to treat various pain conditions and sleep disorders [1,4,5].…”

Efektivitas Fototerapi dan Manajemen Asi terhadap Penurunan Kadar Bilirubin pada Bayi Hiperbilirubinemia

“…Manajemen terapi hiperbilirubinemia yang direkomendasikan adalah fototerapi. Lama pemberian fototerapi tergantung pada kadar biliribun dan alat yang digunakan (Sun et al, 2023). Terapi lain untuk hiperbilirubinemia adalah pemberian ASI yang tepat.…”

“…Pemberian ASI setiap 3 jam pada bayi yang mendapat fototerapi dimaksudkan untuk meminimalkan timbulnya dehidrasi, meningkatkan stimulasi peristaltik dan memaksimalkan paparan fototerapi. Pemberian ASI dapat mencegah bilirubin diabsorbsi kembali masuk ke sirkulasi darah (Sun et al, 2023).…”

Neonatal Phototherapy—The Need to Measure and Document

“…Approximately 5% to 7.5% of term newborns are treated for elevated bilirubin levels with PT . PT effectively lowers serum bilirubin levels without obvious immediate adverse effects.…”