EFFECT OF PHOTOTHERAPY ON SERUM CALCIUM AND MAGNESIUM LEVELS IN NEWBORNS WITH HYPERBILIRUBINEMIA ADMITTED TO NEONATAL INTENSIVE CARE AT A TERTIARY CARE TEACHING HOSPITAL IN THE KOLHAN REGION OF JHARKHAND
DOI:
https://doi.org/10.22159/ajpcr.2024v17i10.52172Keywords:
Phototherapy, Hyperbilirubinemia, Calcium, and Magnesium.Abstract
Objectives: Neonatal jaundice is a medical condition causing yellowish skin discoloration, leading to hospital readmissions in the first 2 weeks of life. It affects 60% of full-term babies and 80% of premature infants. Severe jaundice can cause kernicterus and neurological damage. Treatment options include phototherapy, exchange transfusions, or pharmacological therapy. Phototherapy is the safest and most effective treatment, but it can lead to hypocalcemia and hypomagnesemia due to its effect on the pineal gland. The present study shows the effect of phototherapy on serum calcium and magnesium levels in hyperbilirubinemia.
Methods: A prospective observational study was conducted on 221 neonates with hyperbilirubinemia who were treated with phototherapy. We measured bilirubin, calcium, and magnesium levels in their blood samples at admission and 48 h after initiation of phototherapy. The data were analyzed using Epi-Info software.
Results: Before phototherapy, the mean serum calcium was 8.79±1.44, but it decreased significantly to 8.13±1.67 (p<0.05). Before phototherapy, the mean serum magnesium level was 3.22±0.72 and reduced considerably to 2.56±0.50 (p<0.05). After phototherapy, total serum bilirubin levels reduced dramatically (from 13.07±3.41 to 8.63±3.10) (p<0.05).
Conclusion: The present study shown that phototherapy has a significant effect on the levels of serum calcium, magnesium, and total serum bilirubin by reducing the level.
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References
Ansong-Assoku B, Shah SD, Adnan M, Ankola PA. Neonatal jaundice. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2024. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532930
Lin F, Xu JX, Wu YH, Ma YB, Yang LY. Clinical features and genetic variations of severe neonatal hyperbilirubinemia: Five case reports. World J Clin Cases. 2022;10(20):6999-7005.
Anderson NB, Calkins KL. Neonatal indirect hyperbilirubinemia.
Neoreviews. 2020;21:E749-60.
Hansen TW, Wong RJ, Stevenson DK. Molecular physiology and pathophysiology of bilirubin handling by the blood, liver, intestine, and brain in the newborn. Physiol Rev. 2020;100(3):1291-346.
Reddy DK, Pandey S. Kernicterus. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2024. Available from: https://www.ncbi.nlm.nih. gov/books/NBK559120
Par EJ, Hughes CA, Derico P. Neonatal hyperbilirubinemia: Evaluation and treatment. Am Fam Physician. 2023;107(5):525-34.
Zhou S, Wu X, Ma A, Zhang M, Liu Y. Analysis of therapeutic effect of intermittent and continuous phototherapy on neonatal hemolytic jaundice. Exp Ther Med. 2019;17:4007-12.
Eghbalian F, Shabani S, Faradmal J, Jenabi E. Effects of phototherapy on the serum magnesium level in neonates with indirect hyperbilirubinemia: A prospective cohort study. Int J Pediatr. 2022;2022:5439630. PMID: 35359348
Wang J, Guo G, Li A, Cai WQ, Wang X. Challenges of phototherapy for neonatal hyperbilirubinemia (Review). ExpTher Med. 2021;21(3):231.
Kale AV, Jadhao PU, Valecha A, Kethepalli S. The effect of phototherapy on serum calcium level in neonates with hyperbilirubinemia: A cross sectional study. Int J Contemp Pediatr. 2020;7:1772-6.
Rozario CI, Pillai PS, Ranamol T. Effect of phototherapy on serum calcium level in term newborns. Int J Contemp Pediatr. 2017;4:1975-9.
Goyal S, Srivastava A, Bhattacharjee P, Goyal I, Malhotra K. Effect of phototherapy on serum calcium levels in neonates receiving phototherapy for neonatal jaundice. Int J Res Med Sci. 2018;6:1992-5.
Yeasmin S, Tarafder SI, Ali R, Saiful Islam IK, Haque S. Effects of phototherapy on hyperbilirubinemia and serum calcium level in neonates admitted in a tertiary care hospital. TAJ. 2020;33(1):5-10.
Singh PK, Chaudhuri PK, Chaudhary AK. Phototherapy induced hypocalcemia in neonatal. Hyperbilirubinemia. 2017;16(4):35-8.
Gupta A, Gupta P, Ali S, Gupta S. Effect of mode of delivery: Normal, induced and caesarean section on neonatal serum bilirubin. Indian J Clin Anato Physiol. 2016;3(3):269-72.
Romagnoli C, Polidori G, Cataldi L, Tortorolo G, Segni G. Phototherapy- induced hypocalcemia. J Pediatr. 1979;94(5):815-6.
Hakanson D, Penny R, Bergstrom WH. Calcemic responses to photic and pharmacologic manipulation of serum melatonin. Pediatr Res. 1987;22(4):414-6.
Alizadeh-Taheri P, Sajjadian N, Eivazzadeh B. Prevalence of phototherapy induced hypocalcemia in term neonate. Iran J Pediatr. 2013;23(6):710-1.
Panneerselvam K, Mani S, Vasudevan N, Preethi S, Krishnamoorthy N, Pratibha RK, et al. Effect of light-emitting diode phototherapy on serum calcium levels in neonates with jaundice. Cureus. 2022;14(4):e23938.
Elshenawi HA, Abdelatty RE, Abdelgawad ER, Ramadan IA. Effect of phototherapy on serum calcium and magnesium levels in neonates receiving phototherapy for neonatal jaundice. Egypt J Hosp Med. 2021;85(1):3402-6.
Sethi H, Saili A, Dutta AK. Phototherapy induced hypocalcemia. Indian Pediatr. 1993;30(12):1403-6.
Shahriarpanah S, Tehrani FH, Davati A, Ansari I. Effect of phototherapy on serum level of calcium, magnesium and vitamin D in infants with hyperbilirubinemia. Iran J Pathol. 2018;13(3):357-62.
Sapkota NK. Effect of phototherapy on serum bilirubin and ionzed magnesium level in hyper - bilirubinemic neonates. Innov J Med Sci. 2017;5(1):29-30.
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