Phototherapy Induced Hypocalcemia in Neonatal Hyperbilirubinemia

Singh, Pankaj Kumar; Chaudhuri, Partha Kumar; Chaudhary, Anil

doi:10.9790/0853-1604083538

Cited by 12 publications

(8 citation statements)

References 4 publications

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“…Regarding serum level of magnesium in the study, the average was 2.06 ± 0.39 mg/dL after phototherapy, which was less than that of the hospitalization time (2.21 ± 0.57 mg/dL) and this decrease is not compatible with our study, in which the difference of serum magnesium before and after phototherapy was statistically non-significant (14) . Also, the outcomes of the our study are in accordance with those of the investigations by Singh et al (15) that showed after 48 hour phototherapy a significant fall in calcium level in 30% of term & 70% of preterm neonates was observed. Also Jain (16) found that 35% of preterm and 39% of full-term infants developed hypocalcaemia.…”

Section: Discussionsupporting

confidence: 92%

Effect of Phototherapy on Serum Calcium and Magnesium Levels in Neonates Receiving Phototherapy for Neonatal Jaundice

elshenawi

Abdelatty²,

Abdel-Gawad³

et al. 2021

The Egyptian Journal of Hospital Medicine

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Background: Neonatal hyperbilirubinemia is one of the most common newborn entities. Phototherapy has been the therapy of choice for neonates suffering from indirect hyperbilirubinemia. One of the consequences of phototherapy is hypocalcaemia and hypomagnesaemia. Phototherapy leads to inhibition of pineal gland by transcranial illumination resulting in a decline in melatonin level, which leads to increased calcium absorption by bones. Patients and Methods: This study was conducted on 50 full-term jaundiced neonates (23 males & 27 females) received phototherapy for treatment of neonatal indirect hyperbilirubinemia. Cases were selected from those admitted to NICU of Benha University Hospital. Serum calcium, serum magnesium were measured in their blood samples before phototherapy and after 48 hours and at the end of phototherapy. Results: In our study hypocalcemia was assessed as a complication of phototherapy in newborns managed for neonatal hyperbilirubinemia as mean calcium was 8.63 ± 1.54 mg/dl pre-phototherapy and was 8.22 ± 1.64 mg/dl postphototherapy. The difference was as statistically significant (p < 0.001). Calcium level was lower after phototherapy. Pre-phototherapy, 12 (24.0%) showed hypocalcemia (< 8 mg/dl) and 38 (76.0%) showed normal calcium (> 8 md/dl). Post-phototherapy, 19 (38.0%) showed hypocalcemia (< 8 mg/dl) and 31 (62.0%) showed normal calcium (> 8 md/dl). The difference was as statistically significant (p = 0.039). Hypocalcemia was higher after phototherapy. Whereas, mean Mg was 2.25 ± 0.32 mg/dl pre-phototherapy and was 2.03 ± 0.38 mg/dl post-phototherapy. The difference was as statistically significant (p < 0.001). Mg level was lower after phototherapy. Pre-phototherapy, 11 (22.0 %) showed hypo and 39 (78.0 %) showed normal. Post-phototherapy, 17 (34.0 %) showed hypo and 33 (66.0 %) showed normal. The difference was as statistically non-significant (p = 0.238). Conclusion: Hypocalcemia is a common complication of phototherapy whereas hypomagnesaemia cannot be considered as a complication of phototherapy.

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Section: Discussionsupporting

confidence: 92%

Effect of Phototherapy on Serum Calcium and Magnesium Levels in Neonates Receiving Phototherapy for Neonatal Jaundice

elshenawi

Abdelatty²,

Abdel-Gawad³

et al. 2021

The Egyptian Journal of Hospital Medicine

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“…This was in correlation with studies done by Bahbah et al (8.58±0.76) and Singh et al (8.42±1.19). 5,6 In an Iranian study, 7.5% neonates developed hypocalcemia after receiving phototherapy. 7 In our study, hypocalcemia was observed in 35.0% of neonates after phototherapy.…”

Section: Discussionmentioning

confidence: 99%

Effect of phototherapy on serum calcium levels in neonates receiving phototherapy for neonatal jaundice

et al. 2018

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Background: To study the occurrence of hypocalcaemia in neonates with physiological unconjugated hyperbilirubinemia after 48 hours of phototherapy or at the end of phototherapy, in case duration of phototherapy was less than 48 hours.Methods: This prospective study was conducted on 100 term neonates (61 males and 39 females) admitted to Neonatal intensive care unit of Teerthankar Mahaveer Medical College, Moradabad with unconjugated hyperbilirubinemia and requiring phototherapy. Total Serum bilirubin levels and serum calcium levels were checked before and after phototherapy. Neonates were assessed for clinical features of hypocalcemia i.e. jitteriness, irritability/excitability, lethargy and convulsions.Results: After phototherapy, there was hypocalcemia in 35.0% neonates. The difference between pre and post phototherapy serum calcium levels were found to be statistically significant (p <0.001). 2.86% of neonates developed jitteriness among those who had hypocalcemia. Hypocalcemia was more in subjects who received phototherapy for longer duration.Conclusions: Hypocalcaemia is a common complication of phototherapy. Therefore, calcium supplementation should be done in all neonates undergoing phototherapy.

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“…Change in calcium level was statistically significant (p˂0.05). 15 In a study by Goyal S et al mean serum calcium levels before phototherapy was 9.14±0.78mg/dl and it reduced to 8.53±0.77mg/dl after phototherapy. The reduction was statistically significant (p<0.001).…”

Section: Discussionmentioning

confidence: 96%

Phototherapy Induced Hypocalcaemia in Neonates with Jaundice

Kanodia

2021

J. Nepalgunj Med. College

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Introduction: Neonatal hyperbilirubinemia is seen mainly in the first week of life and in many of the cases it is only in physiological range which requires no intervention. Approximately 5-10% of them have clinically significant jaundice that requires phototherapy and even exchange transfusion. Phototherapy can produce various adverse effects; hypocalcaemia is one of the lesser known effects. So, estimation of calcium levels before and after phototherapy should be done in neonates with jaundice. Aims: The aim of this study is to determine hypocalcaemia, in neonates receiving phototherapy, by measuring serum calcium levels. Methods: This cross sectional study was conducted, from February 2020 to August 2020, on 50 neonates admitted in Neonatal Intensive Care Unit of Nepalgunj Medical College, Kohalpur with unconjugated hyperbilirubinemia requiring phototherapy. Serum calcium levels were evaluated before and after phototherapy. Neonates were assessed for clinical features of hypocalcaemia i.e. jitteriness, irritability/ excitability and convulsions. Data were analyzed using SPSS version 25.P value <0.05 was taken as significant. Results: Frequency of hypocalcaemia after phototherapy was 26%. There was significant change in serum calcium levels before and after phototherapy (p<0.01). Among hypocalcaemic neonates, 56% were symptomatic; 38% developed jitteriness, 18% developed irritability / excitability and none of them developed convulsions. Conclusion: Neonates undergoing phototherapy are at increased risk for hypocalcaemia. Monitoring for hypocalcaemia and its complications should be considered. However, universal recommendation of calcium supplementation is yet to be established but seems reasonable.

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Phototherapy Induced Hypocalcemia in Neonatal Hyperbilirubinemia

Cited by 12 publications

References 4 publications

Effect of Phototherapy on Serum Calcium and Magnesium Levels in Neonates Receiving Phototherapy for Neonatal Jaundice

Effect of Phototherapy on Serum Calcium and Magnesium Levels in Neonates Receiving Phototherapy for Neonatal Jaundice

Effect of phototherapy on serum calcium levels in neonates receiving phototherapy for neonatal jaundice

Phototherapy Induced Hypocalcaemia in Neonates with Jaundice

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