Phototherapy induced hypocalcemia in neonates: A case

Goyal, Madhu; Sharma, Rambabu; Dabi, Dhanraj

doi:10.32677/ijch.2018.v05.i03.015

Cited by 2 publications

(4 citation statements)

References 7 publications

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“…Several investigators who have studied the relationship between phototherapy and serum calcium levels have noted that levels of total and ionized calcium in the serum fall at 48 hours of phototherapy (Table 3). 8,14,16,17 Our study also noted these findings and the fall in the ionic levels was statistically significant. The differences arise regarding the prevalence of hypocalcemia following phototherapy.…”

Section: Discussionsupporting

confidence: 80%

“…8,9,14,15 In contrast, there are investigators who reported lower prevalence of hypocalcemia (sub-10%) in their study populations. 11,12,16,17 Our study has reported the lowest levels for prevalence of hypocalcemia among the studies listed in Table 3. The exact reason for the wide range of prevalence reported has not been probed and could be a research question for future studies.…”

Section: Discussionmentioning

confidence: 68%

“…[9][10][11][12][13][14][15]17 As it has been observed that the degree of reduction in serum calcium levels is related to the duration of exposure to phototherapy, we have included babies who received phototherapy at least for 48 hours and have determined the serum calcium levels on the day, the phototherapy was discontinued. 16 Thus, it can be assumed that the study, by determining the calcium levels after the maximum possible period of exposure to phototherapy, has recorded the nadir of serum calcium levels in the enrolled babies. The absence of a control group may be construed to constitute a limitation.…”

Section: Goyal Et Al 16 India 2018*mentioning

confidence: 99%

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Prevalence of hypocalcemia in term newborns requiring phototherapy

Pereira

Avasthi

Saste

et al. 2023

Int J Contemp Pediatr

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Background: Neonatal hyperbilirubinemia in the first week of life is one of the most prevalent clinical entity observed, affecting 60% of term-babies and 80% of preterm newborn babies, many requiring intervention in the form of phototherapy. The effect of phototherapy on serum calcium levels has not been studied much in Indian literature. The objectives of this study was to evaluate the prevalence of hypocalcemia in healthy, term newborn babies receiving phototherapy for unconjugated hyperbilirubinemia and to determine the association, if any between serum calcium and birth weight, postnatal age at start of phototherapy, weight at enrolment, gestational age at birth, maternal age and duration of phototherapy. Methods: This was a prospective observational study conducted over a period of 10 months among 80 term neonates admitted to the inpatient department at a tertiary care centre in Mumbai. Total serum calcium and ionised calcium levels were measured at the start of phototherapy and on stopping phototherapy/discharge. Data were analysed using statistical package for social sciences (SPSS) version 21 software. Results: Two (2.5%) out of the 80 neonates were found to have hypocalcemia after phototherapy with serum ionic calcium levels less than 1 mmol/l. Even though a larger proportion of neonates showed a decrease in the serum total calcium (56.25%) and serum ionic calcium (58.75%) levels after phototherapy, none of the neonates developed symptomatic hypocalcemia at those levels. A statistically significant association was found between maternal age in years with the serum total calcium levels after phototherapy and age at starting phototherapy (in hours) with the serum ionic calcium levels after phototherapy. Conclusions: The present study concludes that there is significant decrease in the levels of ionised calcium after phototherapy, however there was no significant decrease in the total serum calcium levels and none of the neonates were symptomatic. Hence, we do not recommend regular serum calcium monitoring in healthy term neonates receiving phototherapy and find no indication for the prophylactic use of calcium supplementation in these neonates.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 68%

Section: Goyal Et Al 16 India 2018*mentioning

confidence: 99%

See 1 more Smart Citation

Prevalence of hypocalcemia in term newborns requiring phototherapy

Pereira

Avasthi

Saste

et al. 2023

Int J Contemp Pediatr

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“…26 High toxic levels of bilirubin may contribute to neurodevelopmental problems such as athetosis, hearing loss, and in rare circumstances, intellectual deficiencies. 27 When it first occurs, jaundice caused by physiological immaturity typically lasts between 24 and172 hours, peaks in term1newborns between the fourth & fifth day, or dissipates in1preterm infants at the seventh day. 28 The most common form of bilirubin1is unconjugated & its serum level is often less than 15 mg/dl.…”

Section: Discussionmentioning

confidence: 99%

Does Gender Affect Levels of Hyperbilirubinemia in Term Neonates

Hussain¹,

Parveen²,

Rani³

et al. 2023

PJMHS

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Introduction: Hyperbilirubinemia is a common & in most1cases, benign problem in1first month of1life which is often1physiologic & intervention is not1usually1necessary. In the first week of life, about 60.0% of term & 80.0% of preterm infants have jaundice. Jaundice could lead to major side effects like kernicterus and permanent impairment.1One of the most frequent disorders requiring medical1attention in babies is neonatal jaundice. It has high levels of unconjugated1bilirubin, which can occasionally lead to kernicterus. Objective: To determine frequency of hyperbilirubinemia among neonates who present with physiological jaundice and compare the mean levels of hyperbilirubinemia among genders. Methodology: A total of 368 consecutive neonates were included. This cross-sectional study1was conducted at Department of Paediatric Medicine, NICH Karachi during June 2020 to December 2020. All pre-term or term neonates of either gender with physiological jaundice, and get admitted to pediatric medicine department were included in this study. While Neonates who did not survive first 48 hours of life, neonates who were not exclusively breast fed as determined by History were excluded from study. Blood samples1were taken from the patients and concentrations of serum total bilirubin, In the centrifuged venous samples, direct & indirect1bilirubin concentrations were determined. Serum total,1direct& indirect bilirubin was recorded for each patient. Data was analyzed using IBM. SPSS 22 on computer. Results: Mean ±SD age of neonates was 10.6±4.2 days. In distribution of gender, 214 (58.2%) were male while 154 (41.8%) were female. Mean ±SD of birth weight was 3.4±1.8 kg. Mean ±SD of birth weight was 3.4±1.8 kg with min to max 1.5 – 4.5 kg. majority 203 (55.2%) of neonates had birth weight was 1.5 – 3.0 kg. pre term delivery was done in 195 (53%) neonates while 173 (46.7%) were documented in term neonates. Hyperbilirubinemia was found in 156 (42.4%) patients. Mean levels of hyperbilirubinemia in male v/s female was noted as (12.3±3.8) and (11.5±3.4) respectively and P value found to be significant i.e. (P=0.038). Proportion of hyperbilirubinemia was significantly high 92 (52.9%) in neonates with age > 9 days (p=0.00). Advanced maternal age (>30 years) was also significantly associated with hyperbilirubinemia 88 (50.9%), (p=0.002; OR=1.9). C-section was significantly associated with hyperbilirubinemia 99 (49.3%), (p=0.003). Practical Implication: This study aims to provide an answer to the question of whether gender affects the level of hyperbilirubinemia in neonates. The rationale behind this is that because both preterm and term neonates are affected by this condition, if it is determined that one gender is more affected and experiences higher levels of bilirubinemia, neonates of that specific gender can be closely monitored and followed up in the future. Conclusion: It is to be concluded that hyperbilirubinemia is a frequent finding among neonates who present with physiological jaundice. Therefore, to correctly diagnose and treat the disease, both parents and professionals should take precautions. Keywords: 1Hyperbilirubinemia, Neonates, Jaundice, Risk Factors, Etiology, Hemolysis

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Phototherapy induced hypocalcemia in neonates: A case

Cited by 2 publications

References 7 publications

Prevalence of hypocalcemia in term newborns requiring phototherapy

Prevalence of hypocalcemia in term newborns requiring phototherapy

Does Gender Affect Levels of Hyperbilirubinemia in Term Neonates

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